- 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
- $1,375.18 / $2,406.57 / $9,696.00
| Facility | | $1,375.18 | $2,406.57 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $388.28 / $738.44 / $738.44
| Facility | AS | $388.28 | $738.44 | $738.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,769.06 / $3,451.31 / $4,912.79
| Facility | | $1,769.06 | $3,451.31 | $4,912.79 |
- 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 |