- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.56 / $7,119.04 / $17,435.80
| Facility | | $1,375.56 | $7,119.04 | $17,435.80 |
- 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
- $518.66 / $959.54 / $5,341.00
| Facility | | $518.66 | $959.54 | $5,341.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $145.44 / $849.00 / $849.00
| Facility | AS | $145.44 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,045.31 / $1,373.09 / $2,961.89
| Facility | | $1,045.31 | $1,373.09 | $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 |