- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,788.14 / $8,477.27 / $20,928.72
| Facility | | $1,788.14 | $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
- $1,788.14 / $3,129.25 / $5,063.53
| Facility | | $1,788.14 | $3,129.25 | $5,063.53 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $502.82 / $971.87 / $971.87
| Facility | AS | $502.82 | $971.87 | $971.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.11 / $4,504.35 / $6,502.08
| Facility | | $2,324.11 | $4,504.35 | $6,502.08 |
- 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 |