- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- 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
- $7,147.35 / $7,147.35 / $7,147.35
| Facility | | $7,147.35 | $7,147.35 | $7,147.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $689.65 / $1,241.36 / $9,696.00
| Facility | | $689.65 | $1,241.36 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $188.70 / $2,561.73 / $2,561.73
| Facility | AS | $188.70 | $2,561.73 | $2,561.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,736.60 / $9,053.31
| Facility | | $1,089.00 | $1,736.60 | $9,053.31 |
- 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 |