- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $6,760.83 / $25,703.96
| Facility | | $1,949.84 | $6,760.83 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $18,620.87 / $34,673.69
| Facility | | $2,238.72 | $18,620.87 | $34,673.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $23,988.33 / $29,512.09
| Facility | | $2,511.89 | $23,988.33 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,630.27 / $8,511.38
| Facility | | $1,584.89 | $2,630.27 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $426.58 / $794.33 / $794.33
| Facility | AS | $426.58 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $4,570.88 / $12,589.25
| Facility | | $2,884.03 | $4,570.88 | $12,589.25 |