- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $23,483.17
| Facility | | $4,241.22 | $10,431.19 | $23,483.17 |
- 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
- $1,312.89 / $2,297.56 / $8,220.00
| Facility | | $1,312.89 | $2,297.56 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $369.77 / $699.84 / $699.84
| Facility | AS | $369.77 | $699.84 | $699.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,676.29 / $3,281.26 / $4,672.93
| Facility | | $1,676.29 | $3,281.26 | $4,672.93 |
- 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 |