- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,255.58 / $6,732.07 / $20,928.72
| Facility | | $1,255.58 | $6,732.07 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,522.03 / $5,947.70 / $11,504.78
| Facility | | $4,522.03 | $5,947.70 | $11,504.78 |
- 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
- $620.28 / $1,142.20 / $8,163.00
| Facility | | $620.28 | $1,142.20 | $8,163.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $174.73 / $849.00 / $849.00
| Facility | AS | $174.73 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,240.00 / $1,669.68 / $2,961.89
| Facility | | $1,240.00 | $1,669.68 | $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 |