- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.62 / $8,477.27 / $20,928.72
| Facility | | $2,003.62 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.62 / $3,506.34 / $5,734.90
| Facility | | $2,003.62 | $3,506.34 | $5,734.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $562.04 / $1,069.21 / $1,069.21
| Facility | AS | $562.04 | $1,069.21 | $1,069.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,604.59 / $5,067.24 / $7,194.50
| Facility | | $2,604.59 | $5,067.24 | $7,194.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |