- 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
- $973.70 / $1,703.98 / $8,220.00
| Facility | | $973.70 | $1,703.98 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $273.04 / $511.52 / $511.52
| Facility | AS | $273.04 | $511.52 | $511.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,255.39 / $2,453.64 / $3,431.97
| Facility | | $1,255.39 | $2,453.64 | $3,431.97 |
- 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 |