- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,339.12 / $7,119.04 / $16,762.57
| Facility | | $1,339.12 | $7,119.04 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,165.07 / $7,165.07 / $7,165.07
| Facility | | $7,165.07 | $7,165.07 | $7,165.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.46 / $1,193.38 / $9,696.00
| Facility | | $650.46 | $1,193.38 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $182.62 / $2,568.08 / $2,568.08
| Facility | AS | $182.62 | $2,568.08 | $2,568.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,632.02 / $8,748.73
| Facility | | $1,089.00 | $1,632.02 | $8,748.73 |
- 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 |