- 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
- $1,406.26 / $2,139.10 / $13,909.00
| Facility | | $1,406.26 | $2,139.10 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $571.47 / $571.47 / $571.47
| Facility | AS | $571.47 | $571.47 | $571.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,212.92 / $2,750.05 / $3,715.46
| Facility | | $2,212.92 | $2,750.05 | $3,715.46 |
- 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 |