- 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
- $1,473.05 / $2,577.84 / $9,696.00
| Facility | | $1,473.05 | $2,577.84 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $414.08 / $764.78 / $764.78
| Facility | AS | $414.08 | $764.78 | $764.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.46 / $3,676.84 / $5,114.63
| Facility | | $1,910.46 | $3,676.84 | $5,114.63 |
- 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 |