- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,301.06 / $8,355.33 / $19,276.96
| Facility | | $3,301.06 | $8,355.33 | $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
- $452.89 / $792.56 / $5,405.32
| Facility | | $452.89 | $792.56 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.41 / $849.00 / $849.00
| Facility | AS | $128.41 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $911.45 / $1,216.22 / $2,961.89
| Facility | | $911.45 | $1,216.22 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |