- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,176.33 / $5,946.00 / $17,491.50
| Facility | | $1,176.33 | $5,946.00 | $17,491.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,997.28 / $12,508.22 / $19,618.43
| Facility | | $7,997.28 | $12,508.22 | $19,618.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,586.80 / $7,586.80 / $7,586.80
| Facility | | $7,586.80 | $7,586.80 | $7,586.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.84 / $1,320.54 / $14,063.00
| Facility | | $947.84 | $1,320.54 | $14,063.00 |
- 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
- $1,851.00 / $7,074.00 / $14,139.00
| Facility | | $1,851.00 | $7,074.00 | $14,139.00 |