- 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
- $1,465.68 / $2,564.94 / $9,696.00
| Facility | | $1,465.68 | $2,564.94 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $414.09 / $776.74 / $776.74
| Facility | AS | $414.09 | $776.74 | $776.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,895.36 / $3,693.59 / $5,152.63
| Facility | | $1,895.36 | $3,693.59 | $5,152.63 |
- 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 |