- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,129.65 / $3,636.59 / $12,765.09
| Facility | | $1,129.65 | $3,636.59 | $12,765.09 |
- 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
- $7,172.79 / $7,172.79 / $7,172.79
| Facility | | $7,172.79 | $7,172.79 | $7,172.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.27 / $1,204.84 / $9,496.00
| Facility | | $651.27 | $1,204.84 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.94 / $2,570.85 / $2,570.85
| Facility | AS | $181.94 | $2,570.85 | $2,570.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,628.08 / $8,871.08
| Facility | | $953.00 | $1,628.08 | $8,871.08 |
- 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 |