- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,541.21 / $10,431.19 / $21,899.37
| Facility | | $2,541.21 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,495.51 / $9,858.65 / $19,069.81
| Facility | | $7,495.51 | $9,858.65 | $19,069.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,927.89 / $6,927.89 / $6,927.89
| Facility | | $6,927.89 | $6,927.89 | $6,927.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.49 / $1,224.10 / $8,816.00
| Facility | | $699.49 | $1,224.10 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $193.65 / $2,483.07 / $2,483.07
| Facility | AS | $193.65 | $2,483.07 | $2,483.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,214.00 / $1,734.25 / $8,775.32
| Facility | | $1,214.00 | $1,734.25 | $8,775.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |