- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,936.47 / $10,035.20 / $18,123.39
| Facility | | $2,936.47 | $10,035.20 | $18,123.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,697.64 / $14,313.12 / $25,744.16
| Facility | | $5,697.64 | $14,313.12 | $25,744.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $890.00 / $14,320.91
| Facility | | $580.00 | $890.00 | $14,320.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $126.35 / $126.35 / $126.35
| Facility | AS | $126.35 | $126.35 | $126.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,208.74 / $1,539.25 / $2,420.40
| Facility | | $1,208.74 | $1,539.25 | $2,420.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $182.34 / $220.22 / $318.57
| Facility | AS | $182.34 | $220.22 | $318.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |