- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $4,778.89 / $13,841.56
| Facility | | $1,653.00 | $4,778.89 | $13,841.56 |
- 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
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $445.07 / $778.87 / $5,405.32
| Facility | | $445.07 | $778.87 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.62 / $849.00 / $849.00
| Facility | AS | $125.62 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $860.00 / $1,197.73 / $2,961.89
| Facility | | $860.00 | $1,197.73 | $2,961.89 |
- 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 |