- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $8,511.38 / $19,952.62
| Facility | | $4,265.80 | $8,511.38 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,454.40 / $19,054.61 / $37,153.52
| Facility | | $14,454.40 | $19,054.61 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,698.24 / $8,128.31
| Facility | | $977.24 | $1,698.24 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $501.19 / $501.19 / $501.19
| Facility | AS | $501.19 | $501.19 | $501.19 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,511.89 / $3,467.37
| Professional | | $2,041.74 | $2,511.89 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $7,762.47 / $11,748.98
| Facility | | $7,079.46 | $7,762.47 | $11,748.98 |