- 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
- $15,856.25 / $22,987.11 / $40,340.87
| Facility | | $15,856.25 | $22,987.11 | $40,340.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,127.73 / $2,033.02 / $2,867.53
| Facility | | $1,127.73 | $2,033.02 | $2,867.53 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $621.27 / $621.27 / $621.27
| Facility | AS | $621.27 | $621.27 | $621.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,025.13 / $2,986.88 / $3,984.55
| Facility | | $2,025.13 | $2,986.88 | $3,984.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |