- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,166.29 / $5,909.48 / $24,068.03
| Facility | | $2,166.29 | $5,909.48 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,283.48 / $11,226.25 / $21,074.53
| Facility | | $8,283.48 | $11,226.25 | $21,074.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $746.53 / $1,477.79 / $29,797.02
| Facility | | $746.53 | $1,477.79 | $29,797.02 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $9,295.29 / $9,295.29 / $9,295.29
| Facility | AS | $9,295.29 | $9,295.29 | $9,295.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,408.67 / $1,876.17 / $32,850.11
| Facility | | $1,408.67 | $1,876.17 | $32,850.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,617.00 / $11,459.00 / $26,782.00
| Facility | | $9,617.00 | $11,459.00 | $26,782.00 |