- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,988.53 / $8,477.27 / $20,928.72
| Facility | | $1,988.53 | $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
- $1,988.53 / $3,479.93 / $5,734.90
| Facility | | $1,988.53 | $3,479.93 | $5,734.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $559.38 / $1,057.84 / $1,057.84
| Facility | AS | $559.38 | $1,057.84 | $1,057.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,581.19 / $5,006.58 / $7,009.93
| Facility | | $2,581.19 | $5,006.58 | $7,009.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,126.00 / $4,317.00 / $7,856.00
| Facility | | $3,126.00 | $4,317.00 | $7,856.00 |