- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,083.01 / $8,477.27 / $28,666.76
| Facility | | $3,083.01 | $8,477.27 | $28,666.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,768.41 / $6,768.41 / $6,768.41
| Facility | | $6,768.41 | $6,768.41 | $6,768.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $600.46 / $1,080.83 / $9,496.00
| Facility | | $600.46 | $1,080.83 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.67 / $2,425.91 / $2,425.91
| Facility | AS | $169.67 | $2,425.91 | $2,425.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,551.10 / $8,568.12
| Facility | | $1,089.00 | $1,551.10 | $8,568.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |