- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,328.25 / $14,496.00 / $95,811.38
| Facility | | $8,328.25 | $14,496.00 | $95,811.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,033.43 / $1,154.58 / $1,257.94
| Facility | | $1,033.43 | $1,154.58 | $1,257.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,112.54 / $1,112.54 / $1,112.54
| Facility | | $1,112.54 | $1,112.54 | $1,112.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $109.09 / $109.09 / $109.09
| Facility | AS | $109.09 | $109.09 | $109.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,584.65 / $40,046.08 / $74,512.44
| Facility | | $6,584.65 | $40,046.08 | $74,512.44 |