- 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
- $14,535.24 / $21,072.03 / $36,980.03
| Facility | | $14,535.24 | $21,072.03 | $36,980.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $627.01 / $1,065.92 / $2,020.73
| Facility | | $627.01 | $1,065.92 | $2,020.73 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $382.77 / $382.77 / $382.77
| Facility | AS | $382.77 | $382.77 | $382.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.00 / $1,549.49 / $2,058.12
| Facility | | $1,083.00 | $1,549.49 | $2,058.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |