- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,602.14 / $7,119.04 / $16,762.57
| Facility | | $1,602.14 | $7,119.04 | $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
- $459.77 / $855.45 / $5,405.32
| Facility | | $459.77 | $855.45 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $127.80 / $849.00 / $849.00
| Facility | AS | $127.80 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $921.66 / $1,239.89 / $2,961.89
| Facility | | $921.66 | $1,239.89 | $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 |