- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- 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
- $855.57 / $1,497.25 / $6,805.50
| Facility | | $855.57 | $1,497.25 | $6,805.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $242.85 / $451.87 / $451.87
| Facility | AS | $242.85 | $451.87 | $451.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.01 / $2,129.90 / $2,782.48
| Facility | | $1,084.01 | $2,129.90 | $2,782.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |