- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,735.08 / $44,370.85 / $85,827.55
| Facility | | $33,735.08 | $44,370.85 | $85,827.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,707.18 / $3,962.26 / $13,909.00
| Facility | | $2,707.18 | $3,962.26 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,092.52 / $1,092.52 / $1,092.52
| Facility | AS | $1,092.52 | $1,092.52 | $1,092.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,256.06 / $5,289.09 / $7,129.28
| Facility | | $4,256.06 | $5,289.09 | $7,129.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |