- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,003.16 / $2,973.00 / $8,404.77
| Facility | | $1,003.16 | $2,973.00 | $8,404.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,302.48 / $14,586.84 / $22,756.67
| Facility | | $9,302.48 | $14,586.84 | $22,756.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,159.03 / $7,159.03 / $7,159.03
| Facility | | $7,159.03 | $7,159.03 | $7,159.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $750.42 / $1,056.79 / $8,986.49
| Facility | | $750.42 | $1,056.79 | $8,986.49 |
- 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
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |