- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,849.89 / $7,119.04 / $19,276.96
| Facility | | $3,849.89 | $7,119.04 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,896.35 / $6,440.04 / $12,457.11
| Facility | | $4,896.35 | $6,440.04 | $12,457.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.33 / $1,188.58 / $4,767.99
| Facility | | $660.33 | $1,188.58 | $4,767.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $184.92 / $646.16 / $646.16
| Facility | AS | $184.92 | $646.16 | $646.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.33 / $1,783.79 / $2,283.61
| Facility | | $1,095.33 | $1,783.79 | $2,283.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |