- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $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
- $461.64 / $807.87 / $5,405.32
| Facility | | $461.64 | $807.87 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $129.69 / $849.00 / $849.00
| Facility | AS | $129.69 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $929.06 / $1,236.82 / $2,961.89
| Facility | | $929.06 | $1,236.82 | $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 |