- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $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
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $490.59 / $858.53 / $4,767.99
| Facility | | $490.59 | $858.53 | $4,767.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.53 / $646.16 / $646.16
| Facility | AS | $138.53 | $646.16 | $646.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $742.07 / $1,321.61 / $2,256.42
| Facility | | $742.07 | $1,321.61 | $2,256.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |