- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.57 / $8,355.33 / $17,458.62
| Facility | | $3,964.57 | $8,355.33 | $17,458.62 |
- 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
- $6,912.44 / $6,912.44 / $6,912.44
| Facility | | $6,912.44 | $6,912.44 | $6,912.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.59 / $1,524.92 / $9,496.00
| Facility | | $802.59 | $1,524.92 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $223.97 / $2,477.53 / $2,477.53
| Facility | AS | $223.97 | $2,477.53 | $2,477.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $2,046.56 / $8,705.51
| Facility | | $1,089.00 | $2,046.56 | $8,705.51 |
- 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 |