- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.50 / $11,492.20 / $24,068.03
| Facility | | $4,570.50 | $11,492.20 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,999.34 / $17,097.68 / $33,072.44
| Facility | | $12,999.34 | $17,097.68 | $33,072.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,623.29 / $13,623.29 / $13,623.29
| Facility | | $13,623.29 | $13,623.29 | $13,623.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,038.22 / $1,868.80 / $14,359.20
| Facility | | $1,038.22 | $1,868.80 | $14,359.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $291.30 / $4,882.81 / $4,882.81
| Facility | AS | $291.30 | $4,882.81 | $4,882.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,090.32 / $2,799.02 / $17,366.13
| Facility | | $2,090.32 | $2,799.02 | $17,366.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,148.00 / $9,696.00 / $15,622.00
| Facility | | $8,148.00 | $9,696.00 | $15,622.00 |