- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,943.28 / $13,489.63
| Facility | | $4,265.80 | $7,943.28 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $10,715.19 / $20,892.96
| Facility | | $8,128.31 | $10,715.19 | $20,892.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $954.99 / $10,471.29
| Facility | | $524.81 | $954.99 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.91 / $2,454.71 / $2,454.71
| Facility | AS | $147.91 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,288.25 / $1,778.28
| Professional | | $1,096.48 | $1,288.25 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,413.10 / $7,413.10 / $7,413.10
| Facility | | $7,413.10 | $7,413.10 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $8,511.38 / $10,000.00
| Facility | | $6,918.31 | $8,511.38 | $10,000.00 |