- 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
- $4,306.43 / $5,664.13 / $10,956.25
| Facility | | $4,306.43 | $5,664.13 | $10,956.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,702.06 / $6,702.06 / $6,702.06
| Facility | | $6,702.06 | $6,702.06 | $6,702.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $732.17 / $1,317.91 / $9,496.00
| Facility | | $732.17 | $1,317.91 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $205.74 / $2,402.13 / $2,402.13
| Facility | AS | $205.74 | $2,402.13 | $2,402.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $1,829.48 / $8,573.23
| Facility | | $1,392.00 | $1,829.48 | $8,573.23 |
- 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 |