- 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
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,567.35 / $2,742.86 / $8,220.00
| Facility | | $1,567.35 | $2,742.86 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $441.09 / $824.88 / $824.88
| Facility | AS | $441.09 | $824.88 | $824.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,024.13 / $3,941.85 / $5,531.17
| Facility | | $2,024.13 | $3,941.85 | $5,531.17 |
- 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 |