- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,630.27 / $6,606.93
| Facility | | $912.01 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $39,810.72 / $64,565.42
| Facility | | $25,703.96 | $39,810.72 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $8,709.64 / $33,884.42
| Facility | | $478.63 | $8,709.64 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $10,715.19
| Facility | AS | $10,715.19 | $10,715.19 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $20,892.96 / $36,307.81
| Facility | | $6,918.31 | $20,892.96 | $36,307.81 |