- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,335.06 / $35,048.87 / $52,080.70
| Facility | | $32,335.06 | $35,048.87 | $52,080.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,039.91 / $1,247.89 / $1,359.60
| Facility | | $1,039.91 | $1,247.89 | $1,359.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,205.52 / $1,205.52 / $1,205.52
| Facility | | $1,205.52 | $1,205.52 | $1,205.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $118.93 / $118.93 / $118.93
| Facility | AS | $118.93 | $118.93 | $118.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,424.84 / $31,720.44 / $56,159.40
| Facility | | $11,424.84 | $31,720.44 | $56,159.40 |