- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,194.72 / $4,278.21 / $12,036.14
| Facility | | $1,194.72 | $4,278.21 | $12,036.14 |
- 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
- $6,870.18 / $6,870.18 / $6,870.18
| Facility | | $6,870.18 | $6,870.18 | $6,870.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $590.15 / $1,091.78 / $8,632.00
| Facility | | $590.15 | $1,091.78 | $8,632.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.43 / $2,462.39 / $2,462.39
| Facility | AS | $165.43 | $2,462.39 | $2,462.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,546.12 / $8,443.70
| Facility | | $953.00 | $1,546.12 | $8,443.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |