- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,355.33 / $19,276.96
| Facility | | $4,083.97 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,609.82 / $6,063.17 / $11,728.12
| Facility | | $4,609.82 | $6,063.17 | $11,728.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,802.85 / $1,802.85 / $1,802.85
| Facility | | $1,802.85 | $1,802.85 | $1,802.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $664.44 / $1,162.77 / $4,767.99
| Facility | | $664.44 | $1,162.77 | $4,767.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $185.88 / $646.16 / $646.16
| Facility | AS | $185.88 | $646.16 | $646.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,120.89 / $1,789.06 / $2,283.61
| Facility | | $1,120.89 | $1,789.06 | $2,283.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |