- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,346.24 / $8,477.27 / $20,928.72
| Facility | | $3,346.24 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,416.80 / $9,302.56 / $16,325.39
| Facility | | $6,416.80 | $9,302.56 | $16,325.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.83 / $540.45 / $3,068.98
| Facility | | $308.83 | $540.45 | $3,068.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $779.95 / $1,537.78 / $1,537.78
| Facility | AS | $779.95 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.28 / $836.31 / $5,090.60
| Facility | | $606.28 | $836.31 | $5,090.60 |
- 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 |