- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,596.32 / $10,255.42 / $23,483.17
| Facility | | $2,596.32 | $10,255.42 | $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
- $1,349.62 / $2,389.91 / $15,622.00
| Facility | | $1,349.62 | $2,389.91 | $15,622.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.58 / $722.70 / $722.70
| Facility | AS | $380.58 | $722.70 | $722.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,767.56 / $3,436.63 / $4,897.16
| Facility | | $1,767.56 | $3,436.63 | $4,897.16 |
- 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 |