- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,650.53 / $7,119.04 / $16,762.57
| Facility | | $1,650.53 | $7,119.04 | $16,762.57 |
- 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
- $686.77 / $1,201.84 / $8,816.00
| Facility | | $686.77 | $1,201.84 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.35 / $1,887.52 / $1,887.52
| Facility | AS | $194.35 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,729.69 / $6,616.19
| Facility | | $1,089.00 | $1,729.69 | $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 |