- 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
- $8,018.72 / $10,546.81 / $20,400.93
| Facility | | $8,018.72 | $10,546.81 | $20,400.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,951.09 / $12,951.09 / $12,951.09
| Facility | | $12,951.09 | $12,951.09 | $12,951.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.69 / $1,390.71 / $9,696.00
| Facility | | $794.69 | $1,390.71 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $224.36 / $4,641.89 / $4,641.89
| Facility | AS | $224.36 | $4,641.89 | $4,641.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $1,991.71 / $16,975.80
| Facility | | $1,392.00 | $1,991.71 | $16,975.80 |
- 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 |