- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,347.52 / $17,865.64 / $22,570.34
| Facility | | $10,347.52 | $17,865.64 | $22,570.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.55 / $841.45 / $916.77
| Facility | | $750.55 | $841.45 | $916.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $804.59 / $804.59 / $804.59
| Facility | | $804.59 | $804.59 | $804.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $79.45 / $79.45 / $79.45
| Facility | AS | $79.45 | $79.45 | $79.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,827.43 / $24,480.92 / $35,343.47
| Facility | | $8,827.43 | $24,480.92 | $35,343.47 |