- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,917.20 / $8,477.27 / $19,276.96
| Facility | | $4,917.20 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,193.47 / $8,978.79 / $15,757.21
| Facility | | $6,193.47 | $8,978.79 | $15,757.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.82 / $675.19 / $1,277.47
| Facility | | $385.82 | $675.19 | $1,277.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,568.44 / $1,568.44 / $1,568.44
| Facility | AS | $1,568.44 | $1,568.44 | $1,568.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.31 / $1,034.18 / $5,251.23
| Facility | | $776.31 | $1,034.18 | $5,251.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |