- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $11,100.08 / $21,700.37
| Facility | | $4,083.97 | $11,100.08 | $21,700.37 |
- 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
- $7,059.20 / $7,059.20 / $7,059.20
| Facility | | $7,059.20 | $7,059.20 | $7,059.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.20 / $1,487.16 / $9,496.00
| Facility | | $826.20 | $1,487.16 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $233.05 / $2,530.14 / $2,530.14
| Facility | AS | $233.05 | $2,530.14 | $2,530.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $2,071.42 / $8,941.65
| Facility | | $1,089.00 | $2,071.42 | $8,941.65 |
- 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 |