- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,623.41 / $15,488.17
| Facility | | $2,089.30 | $5,623.41 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $8,128.31 / $22,387.21
| Facility | | $2,238.72 | $8,128.31 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $14,454.40 / $17,782.79
| Facility | | $2,511.89 | $14,454.40 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $2,511.89 / $5,888.44
| Facility | | $1,548.82 | $2,511.89 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $478.63 / $891.25 / $891.25
| Facility | AS | $478.63 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $2,818.38 / $11,220.18
| Facility | | $1,230.27 | $2,818.38 | $11,220.18 |