- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,166.26 / $11,100.08 / $24,068.03
| Facility | | $4,166.26 | $11,100.08 | $24,068.03 |
- 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
- $853.21 / $1,520.89 / $8,632.00
| Facility | | $853.21 | $1,520.89 | $8,632.00 |
- 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
- $1,605.73 / $1,995.47 / $4,164.35
| Facility | | $1,605.73 | $1,995.47 | $4,164.35 |
- 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 |