- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,506.15 / $5,463.36 / $13,841.56
| Facility | | $1,506.15 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $157.13 / $290.69 / $1,300.00
| Facility | | $157.13 | $290.69 | $1,300.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $43.74 / $83.11 / $83.11
| Facility | AS | $43.74 | $83.11 | $83.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $209.35 / $399.56 / $566.25
| Facility | | $209.35 | $399.56 | $566.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |