- 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
- $18,424.50 / $24,233.27 / $46,874.97
| Facility | | $18,424.50 | $24,233.27 | $46,874.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,678.00 / $4,991.56 / $13,909.00
| Facility | | $3,678.00 | $4,991.56 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,510.64 / $1,510.64 / $1,510.64
| Facility | AS | $1,510.64 | $1,510.64 | $1,510.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,877.47 / $7,304.04 / $10,375.15
| Facility | | $5,877.47 | $7,304.04 | $10,375.15 |
- 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 |