- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,757.31 / $7,049.86 / $19,148.84
| Facility | | $1,757.31 | $7,049.86 | $19,148.84 |
- 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
- $568.08 / $1,046.58 / $5,341.00
| Facility | | $568.08 | $1,046.58 | $5,341.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $160.28 / $849.00 / $849.00
| Facility | AS | $160.28 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.00 / $1,530.83 / $2,961.89
| Facility | | $1,130.00 | $1,530.83 | $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 |