- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.78 / $9,016.62 / $16,467.00
| Facility | | $1,026.78 | $9,016.62 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,925.47 / $10,415.50 / $17,689.34
| Facility | | $4,925.47 | $10,415.50 | $17,689.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $917.64 / $1,179.15 / $1,991.84
| Facility | | $917.64 | $1,179.15 | $1,991.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $162.44 / $165.08 / $232.74
| Facility | AS | $162.44 | $165.08 | $232.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |