- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,917.20 / $8,355.33 / $19,276.96
| Facility | | $4,917.20 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,219.04 / $16,264.47 / $28,543.08
| Facility | | $11,219.04 | $16,264.47 | $28,543.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.19 / $1,445.32 / $2,747.36
| Facility | | $850.19 | $1,445.32 | $2,747.36 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,008.48 / $1,008.48 / $1,008.48
| Facility | AS | $1,008.48 | $1,008.48 | $1,008.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,603.14 / $2,150.01 / $3,376.46
| Facility | | $1,603.14 | $2,150.01 | $3,376.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $19,670.00
| Facility | | $8,148.00 | $9,696.00 | $19,670.00 |