- 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
- $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
- $1,087.02 / $1,902.29 / $8,220.00
| Facility | | $1,087.02 | $1,902.29 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $305.14 / $552.54 / $552.54
| Facility | AS | $305.14 | $552.54 | $552.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,394.16 / $2,656.46 / $3,708.32
| Facility | | $1,394.16 | $2,656.46 | $3,708.32 |
- 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 |