- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,860.00 / $10,338.04 / $19,997.13
| Facility | | $7,860.00 | $10,338.04 | $19,997.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $543.77 / $951.60 / $8,163.00
| Facility | | $543.77 | $951.60 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $153.41 / $849.00 / $849.00
| Facility | AS | $153.41 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,378.06 / $2,961.89
| Facility | | $1,089.00 | $1,378.06 | $2,961.89 |
- 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 |