- 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
- $1,070.08 / $1,872.64 / $8,163.00
| Facility | | $1,070.08 | $1,872.64 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $300.10 / $543.30 / $543.30
| Facility | AS | $300.10 | $543.30 | $543.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,364.30 / $2,664.02 / $3,647.86
| Facility | | $1,364.30 | $2,664.02 | $3,647.86 |
- 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 |