- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,906.97 / $8,023.32 / $21,899.37
| Facility | | $3,906.97 | $8,023.32 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,349.44 / $9,666.52 / $18,698.16
| Facility | | $7,349.44 | $9,666.52 | $18,698.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $539.58 / $998.22 / $5,341.00
| Facility | | $539.58 | $998.22 | $5,341.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $152.68 / $849.00 / $849.00
| Facility | AS | $152.68 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,040.00 / $1,457.59 / $2,961.89
| Facility | | $1,040.00 | $1,457.59 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |