- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,541.21 / $8,031.91 / $21,899.37
| Facility | | $2,541.21 | $8,031.91 | $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
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.36 / $1,365.35 / $8,632.00
| Facility | | $748.36 | $1,365.35 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $210.47 / $1,887.52 / $1,887.52
| Facility | AS | $210.47 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $2,014.37 / $6,616.19
| Facility | | $1,392.00 | $2,014.37 | $6,616.19 |
- 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 |