- 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
- $1,145.01 / $2,030.04 / $8,220.00
| Facility | | $1,145.01 | $2,030.04 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $320.97 / $581.61 / $581.61
| Facility | AS | $320.97 | $581.61 | $581.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,465.60 / $2,859.41 / $3,906.45
| Facility | | $1,465.60 | $2,859.41 | $3,906.45 |
- 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 |