- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $7,943.28 / $17,782.79
| Facility | | $2,041.74 | $7,943.28 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $4,365.16 / $7,943.28
| Facility | | $1,659.59 | $4,365.16 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,620.87 / $18,620.87 / $25,118.86
| Facility | | $18,620.87 | $18,620.87 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,089.30 / $16,218.10
| Facility | | $1,584.89 | $2,089.30 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $426.58 / $426.58 / $794.33
| Facility | AS | $426.58 | $426.58 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,244.36 / $23,988.33
| Facility | | $2,818.38 | $7,244.36 | $23,988.33 |