- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,924.95 / $7,119.04 / $19,276.96
| Facility | | $1,924.95 | $7,119.04 | $19,276.96 |
- 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
- $6,946.97 / $6,946.97 / $6,946.97
| Facility | | $6,946.97 | $6,946.97 | $6,946.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,033.78 / $1,912.49 / $9,496.00
| Facility | | $1,033.78 | $1,912.49 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $288.45 / $2,489.91 / $2,489.91
| Facility | AS | $288.45 | $2,489.91 | $2,489.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,314.21 / $2,766.94 / $8,799.49
| Facility | | $1,314.21 | $2,766.94 | $8,799.49 |
- 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 |