- 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
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,566.85 / $2,741.99 / $9,696.00
| Facility | | $1,566.85 | $2,741.99 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $439.59 / $825.64 / $825.64
| Facility | AS | $439.59 | $825.64 | $825.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,016.18 / $3,948.37 / $5,536.68
| Facility | | $2,016.18 | $3,948.37 | $5,536.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |