- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $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
- $6,751.59 / $6,751.59 / $6,751.59
| Facility | | $6,751.59 | $6,751.59 | $6,751.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.97 / $2,095.15 / $8,816.00
| Facility | | $1,163.97 | $2,095.15 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $327.41 / $2,419.88 / $2,419.88
| Facility | AS | $327.41 | $2,419.88 | $2,419.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,488.48 / $2,917.22 / $8,282.04
| Facility | | $1,488.48 | $2,917.22 | $8,282.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |