- 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
- $1,415.10 / $2,476.42 / $8,220.00
| Facility | | $1,415.10 | $2,476.42 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $397.14 / $731.02 / $731.02
| Facility | AS | $397.14 | $731.02 | $731.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.16 / $3,514.52 / $4,910.71
| Facility | | $1,821.16 | $3,514.52 | $4,910.71 |
- 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 |