- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,467.37 / $8,912.51
| Facility | | $1,000.00 | $3,467.37 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,715.19 / $17,782.79
| Facility | | $6,918.31 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $5,248.07 / $15,135.61
| Facility | | $870.96 | $5,248.07 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | AS | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $7,762.47 / $14,125.38
| Facility | | $1,949.84 | $7,762.47 | $14,125.38 |