- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,355.33 / $19,276.96
| Facility | | $4,083.97 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.60 / $1,422.05 / $5,237.05
| Facility | | $812.60 | $1,422.05 | $5,237.05 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $227.46 / $412.36 / $412.36
| Facility | AS | $227.46 | $412.36 | $412.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.98 / $2,031.00 / $2,777.05
| Facility | | $1,040.98 | $2,031.00 | $2,777.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |