- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,898.99 / $7,119.04 / $19,276.96
| Facility | | $2,898.99 | $7,119.04 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,094.34 / $5,385.17 / $10,416.66
| Facility | | $4,094.34 | $5,385.17 | $10,416.66 |
- 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
- $608.87 / $1,122.42 / $7,441.00
| Facility | | $608.87 | $1,122.42 | $7,441.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.81 / $849.00 / $849.00
| Facility | AS | $171.81 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,171.41 / $1,642.08 / $3,000.40
| Facility | | $1,171.41 | $1,642.08 | $3,000.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,038.98 / $5,341.00 / $8,632.00
| Facility | | $4,038.98 | $5,341.00 | $8,632.00 |