- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,412.42 / $10,431.19 / $23,483.17
| Facility | | $2,412.42 | $10,431.19 | $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
- $1,147.83 / $2,008.70 / $9,696.00
| Facility | | $1,147.83 | $2,008.70 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $322.06 / $602.19 / $602.19
| Facility | AS | $322.06 | $602.19 | $602.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.33 / $2,895.17 / $4,045.15
| Facility | | $1,480.33 | $2,895.17 | $4,045.15 |
- 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 |