- 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
- $3,590.34 / $4,787.12 / $13,909.00
| Facility | | $3,590.34 | $4,787.12 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,447.81 / $1,447.81 / $1,447.81
| Facility | AS | $1,447.81 | $1,447.81 | $1,447.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,638.47 / $7,007.03 / $9,958.02
| Facility | | $5,638.47 | $7,007.03 | $9,958.02 |
- 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 |