- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,844.11 / $7,774.80 / $18,002.77
| Facility | | $1,844.11 | $7,774.80 | $18,002.77 |
- 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
- $6,942.42 / $6,942.42 / $6,942.42
| Facility | | $6,942.42 | $6,942.42 | $6,942.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $887.67 / $1,686.57 / $11,035.00
| Facility | | $887.67 | $1,686.57 | $11,035.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $248.41 / $2,488.28 / $2,488.28
| Facility | AS | $248.41 | $2,488.28 | $2,488.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,144.71 / $2,387.32 / $8,793.73
| Facility | | $1,144.71 | $2,387.32 | $8,793.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,939.00 / $8,158.00 / $9,496.00
| Facility | | $6,939.00 | $8,158.00 | $9,496.00 |