- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $13,841.56
| Facility | | $2,318.31 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,218.81 / $10,465.26 / $18,365.84
| Facility | | $7,218.81 | $10,465.26 | $18,365.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.11 / $1,260.93 / $1,776.75
| Facility | | $746.11 | $1,260.93 | $1,776.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $384.81 / $384.81 / $384.81
| Facility | AS | $384.81 | $384.81 | $384.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,324.00 / $1,850.06 / $2,470.82
| Facility | | $1,324.00 | $1,850.06 | $2,470.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,044.00 / $3,726.00 / $7,934.00
| Facility | | $3,044.00 | $3,726.00 | $7,934.00 |