- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- 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
- $850.36 / $1,488.13 / $7,221.00
| Facility | | $850.36 | $1,488.13 | $7,221.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $238.50 / $431.74 / $431.74
| Facility | AS | $238.50 | $431.74 | $431.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,085.48 / $2,120.94 / $2,902.21
| Facility | | $1,085.48 | $2,120.94 | $2,902.21 |
- 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 |