- 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
- $2,913.46 / $4,237.81 / $13,909.00
| Facility | | $2,913.46 | $4,237.81 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,176.83 / $1,176.83 / $1,176.83
| Facility | AS | $1,176.83 | $1,176.83 | $1,176.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,579.00 / $5,699.17 / $7,681.51
| Facility | | $4,579.00 | $5,699.17 | $7,681.51 |
- 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 |