- 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
- $1,110.77 / $1,943.85 / $8,163.00
| Facility | | $1,110.77 | $1,943.85 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $311.73 / $564.65 / $564.65
| Facility | AS | $311.73 | $564.65 | $564.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,429.30 / $2,714.67 / $3,793.81
| Facility | | $1,429.30 | $2,714.67 | $3,793.81 |
- 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 |