- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,545.00 / $5,909.48 / $13,841.56
| Facility | | $1,545.00 | $5,909.48 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $342.90 / $651.51 / $4,803.10
| Facility | | $342.90 | $651.51 | $4,803.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $97.18 / $849.00 / $849.00
| Facility | AS | $97.18 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $646.00 / $922.74 / $2,961.89
| Facility | | $646.00 | $922.74 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |