- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,963.45 / $6,048.00 / $16,762.57
| Facility | | $1,963.45 | $6,048.00 | $16,762.57 |
- 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
- $6,661.17 / $6,661.17 / $6,661.17
| Facility | | $6,661.17 | $6,661.17 | $6,661.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.77 / $1,213.88 / $8,816.00
| Facility | | $660.77 | $1,213.88 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.66 / $2,387.48 / $2,387.48
| Facility | AS | $186.66 | $2,387.48 | $2,387.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,659.85 / $8,332.41
| Facility | | $1,089.00 | $1,659.85 | $8,332.41 |
- 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 |