- 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
- $627.76 / $1,098.58 / $8,220.00
| Facility | | $627.76 | $1,098.58 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $177.44 / $329.26 / $329.26
| Facility | AS | $177.44 | $329.26 | $329.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $790.71 / $1,555.50 / $2,194.10
| Facility | | $790.71 | $1,555.50 | $2,194.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |