- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,124.24 / $4,182.08 / $12,765.09
| Facility | | $1,124.24 | $4,182.08 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,362.84 / $10,999.42 / $21,276.43
| Facility | | $8,362.84 | $10,999.42 | $21,276.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,834.75 / $6,834.75 / $6,834.75
| Facility | | $6,834.75 | $6,834.75 | $6,834.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.70 / $1,107.59 / $9,696.00
| Facility | | $598.70 | $1,107.59 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $168.45 / $2,449.69 / $2,449.69
| Facility | AS | $168.45 | $2,449.69 | $2,449.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,576.01 / $8,705.54
| Facility | | $953.00 | $1,576.01 | $8,705.54 |
- 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 |