- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,047.15 / $15,043.29 / $22,716.74
| Facility | | $9,047.15 | $15,043.29 | $22,716.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,916.00 / $19,321.95 / $41,845.18
| Facility | | $2,916.00 | $19,321.95 | $41,845.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $1,849.74 / $22,898.98
| Facility | | $890.00 | $1,849.74 | $22,898.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $183.13 / $183.13 / $183.13
| Facility | AS | $183.13 | $183.13 | $183.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,800.43 / $2,023.31 / $3,634.42
| Facility | | $1,800.43 | $2,023.31 | $3,634.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $273.75 / $273.95 / $483.60
| Facility | AS | $273.75 | $273.95 | $483.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,766.00 / $17,186.00 / $25,620.00
| Facility | | $8,766.00 | $17,186.00 | $25,620.00 |