- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.51 / $9,858.65 / $19,069.81
| Facility | | $7,495.51 | $9,858.65 | $19,069.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,002.31 / $3,002.31 / $3,002.31
| Facility | | $3,002.31 | $3,002.31 | $3,002.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.53 / $1,355.43 / $7,221.00
| Facility | | $774.53 | $1,355.43 | $7,221.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.14 / $1,076.08 / $1,076.08
| Facility | AS | $218.14 | $1,076.08 | $1,076.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $1,949.46 / $3,802.93
| Facility | | $1,392.00 | $1,949.46 | $3,802.93 |
- 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 |