- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,195.05 / $6,304.12 / $15,306.07
| Facility | | $1,195.05 | $6,304.12 | $15,306.07 |
- 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
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.32 / $1,585.21 / $9,696.00
| Facility | | $834.32 | $1,585.21 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $234.10 / $1,887.52 / $1,887.52
| Facility | AS | $234.10 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,655.67 / $2,246.92 / $6,616.19
| Facility | | $1,655.67 | $2,246.92 | $6,616.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $9,094.60 / $10,575.11
| Facility | | $6,777.00 | $9,094.60 | $10,575.11 |