- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,029.65 / $7,119.04 / $24,068.03
| Facility | | $3,029.65 | $7,119.04 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,851.10 / $6,851.10 / $6,851.10
| Facility | | $6,851.10 | $6,851.10 | $6,851.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.66 / $1,259.39 / $8,944.00
| Facility | | $699.66 | $1,259.39 | $8,944.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $196.41 / $2,455.55 / $2,455.55
| Facility | AS | $196.41 | $2,455.55 | $2,455.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,833.70 / $8,678.06
| Facility | | $1,089.00 | $1,833.70 | $8,678.06 |
- 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 |