- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $8,477.27 / $21,899.37
| Facility | | $4,241.22 | $8,477.27 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,474.97 / $6,064.74 / $11,385.07
| Facility | | $4,474.97 | $6,064.74 | $11,385.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $681.44 / $1,086.93 / $10,946.80
| Facility | | $681.44 | $1,086.93 | $10,946.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,678.13 / $1,678.13 / $1,678.13
| Facility | AS | $1,678.13 | $1,678.13 | $1,678.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,049.95 / $1,537.12 / $6,152.06
| Facility | | $1,049.95 | $1,537.12 | $6,152.06 |
- 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 |