- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- 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
- $999.70 / $1,749.48 / $8,163.00
| Facility | | $999.70 | $1,749.48 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $280.37 / $507.73 / $507.73
| Facility | AS | $280.37 | $507.73 | $507.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,276.94 / $2,488.50 / $3,416.33
| Facility | | $1,276.94 | $2,488.50 | $3,416.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |