- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.65 / $9,144.62 / $17,688.66
| Facility | | $6,952.65 | $9,144.62 | $17,688.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $809.96 / $1,417.43 / $8,816.00
| Facility | | $809.96 | $1,417.43 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $224.92 / $1,625.25 / $1,625.25
| Facility | AS | $224.92 | $1,625.25 | $1,625.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.31 / $1,959.23 / $2,741.61
| Facility | | $1,031.31 | $1,959.23 | $2,741.61 |
- 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 |