- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,752.78 / $10,431.19 / $20,928.72
| Facility | | $3,752.78 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- 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
- $483.24 / $873.79 / $5,405.32
| Facility | | $483.24 | $873.79 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $137.22 / $849.00 / $849.00
| Facility | AS | $137.22 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $916.00 / $1,308.35 / $2,961.89
| Facility | | $916.00 | $1,308.35 | $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 |