- 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
- $1,208.75 / $2,115.31 / $9,696.00
| Facility | | $1,208.75 | $2,115.31 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $340.33 / $631.87 / $631.87
| Facility | AS | $340.33 | $631.87 | $631.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,549.99 / $3,031.78 / $4,201.56
| Facility | | $1,549.99 | $3,031.78 | $4,201.56 |
- 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 |