- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,932.37 / $7,161.40 / $20,928.72
| Facility | | $3,932.37 | $7,161.40 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.46 / $5,516.52 / $10,355.91
| Facility | | $4,070.46 | $5,516.52 | $10,355.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $605.73 / $1,420.16 / $8,223.82
| Facility | | $605.73 | $1,420.16 | $8,223.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,196.53 / $1,196.53 / $1,196.53
| Facility | AS | $1,196.53 | $1,196.53 | $1,196.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.85 / $1,415.35 / $4,164.35
| Facility | | $1,058.85 | $1,415.35 | $4,164.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |