- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,265.38 / $23,483.17
| Facility | | $4,241.22 | $11,265.38 | $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
- $1,864.17 / $3,262.30 / $9,696.00
| Facility | | $1,864.17 | $3,262.30 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $520.80 / $967.18 / $967.18
| Facility | AS | $520.80 | $967.18 | $967.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,413.75 / $4,667.14 / $6,540.65
| Facility | | $2,413.75 | $4,667.14 | $6,540.65 |
- 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 |