- 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
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.49 / $1,140.10 / $9,496.00
| Facility | | $651.49 | $1,140.10 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $184.06 / $342.12 / $342.12
| Facility | AS | $184.06 | $342.12 | $342.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $824.66 / $1,617.74 / $2,284.84
| Facility | | $824.66 | $1,617.74 | $2,284.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,939.00 / $8,158.00 / $9,496.00
| Facility | | $6,939.00 | $8,158.00 | $9,496.00 |