- 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
- $1,436.84 / $2,514.46 / $6,451.00
| Facility | | $1,436.84 | $2,514.46 | $6,451.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $402.19 / $730.11 / $730.11
| Facility | AS | $402.19 | $730.11 | $730.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,855.35 / $3,510.16 / $4,916.95
| Facility | | $1,855.35 | $3,510.16 | $4,916.95 |
- 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 |