- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,904.82 / $6,408.55 / $16,762.57
| Facility | | $1,904.82 | $6,408.55 | $16,762.57 |
- 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
- $604.17 / $1,087.52 / $5,405.32
| Facility | | $604.17 | $1,087.52 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $170.46 / $849.00 / $849.00
| Facility | AS | $170.46 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,516.11 / $2,961.89
| Facility | | $1,089.00 | $1,516.11 | $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 |