- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,255.42 / $23,483.17
| Facility | | $4,241.22 | $10,255.42 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,999.34 / $17,097.68 / $33,072.44
| Facility | | $12,999.34 | $17,097.68 | $33,072.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,012.50 / $1,771.88 / $8,220.00
| Facility | | $1,012.50 | $1,771.88 | $8,220.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $284.12 / $511.97 / $511.97
| Facility | AS | $284.12 | $511.97 | $511.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,295.50 / $2,529.81 / $3,424.67
| Facility | | $1,295.50 | $2,529.81 | $3,424.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |