- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.39 / $8,477.27 / $20,928.72
| Facility | | $764.39 | $8,477.27 | $20,928.72 |
- 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
- $7,569.45 / $7,569.45 / $7,569.45
| Facility | | $7,569.45 | $7,569.45 | $7,569.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.02 / $1,084.96 / $8,163.00
| Facility | | $675.02 | $1,084.96 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $283.69 / $283.69 / $283.69
| Facility | AS | $283.69 | $283.69 | $283.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.51 / $1,801.31 / $9,083.34
| Facility | | $1,298.51 | $1,801.31 | $9,083.34 |
- 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 |