- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,535.25 / $8,042.03 / $19,276.96
| Facility | | $1,535.25 | $8,042.03 | $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
- $6,728.42 / $6,728.42 / $6,728.42
| Facility | | $6,728.42 | $6,728.42 | $6,728.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $762.41 / $1,372.34 / $9,696.00
| Facility | | $762.41 | $1,372.34 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $214.60 / $2,411.58 / $2,411.58
| Facility | AS | $214.60 | $2,411.58 | $2,411.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,915.96 / $8,522.66
| Facility | | $1,089.00 | $1,915.96 | $8,522.66 |
- 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 |