- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,611.47 / $24,068.03
| Facility | | $4,241.22 | $11,611.47 | $24,068.03 |
- 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
- $3,061.38 / $3,061.38 / $3,061.38
| Facility | | $3,061.38 | $3,061.38 | $3,061.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $774.09 / $1,354.66 / $5,405.32
| Facility | | $774.09 | $1,354.66 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $215.73 / $1,097.25 / $1,097.25
| Facility | AS | $215.73 | $1,097.25 | $1,097.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,474.00 / $2,062.21 / $3,877.75
| Facility | | $1,474.00 | $2,062.21 | $3,877.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |