- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,010.30 / $8,042.03 / $19,276.96
| Facility | | $3,010.30 | $8,042.03 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,949.61 / $3,879.54 / $7,504.28
| Facility | | $2,949.61 | $3,879.54 | $7,504.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.42 / $1,062.42 / $1,062.42
| Facility | | $1,062.42 | $1,062.42 | $1,062.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $503.85 / $881.74 / $4,017.35
| Facility | | $503.85 | $881.74 | $4,017.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $142.76 / $380.79 / $380.79
| Facility | AS | $142.76 | $380.79 | $380.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.56 / $1,230.71 / $1,627.76
| Facility | | $826.56 | $1,230.71 | $1,627.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,711.00 / $5,356.00 / $7,772.00
| Facility | | $3,711.00 | $5,356.00 | $7,772.00 |