- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,301.06 / $8,042.03 / $19,276.96
| Facility | | $3,301.06 | $8,042.03 | $19,276.96 |
- 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
- $537.63 / $940.85 / $5,405.32
| Facility | | $537.63 | $940.85 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $151.54 / $849.00 / $849.00
| Facility | AS | $151.54 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.61 / $1,364.36 / $2,961.89
| Facility | | $1,083.61 | $1,364.36 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,529.66 / $8,163.00 / $9,696.00
| Facility | | $2,529.66 | $8,163.00 | $9,696.00 |