- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,506.16 / $24,068.03
| Facility | | $4,241.22 | $10,506.16 | $24,068.03 |
- 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
- $1,211.27 / $2,119.71 / $7,441.00
| Facility | | $1,211.27 | $2,119.71 | $7,441.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $339.92 / $615.52 / $615.52
| Facility | AS | $339.92 | $615.52 | $615.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,552.94 / $2,959.22 / $4,131.72
| Facility | | $1,552.94 | $2,959.22 | $4,131.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |