- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,262.57 / $6,646.00 / $13,115.52
| Facility | | $1,262.57 | $6,646.00 | $13,115.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,224.00 / $4,500.00 / $10,043.00
| Facility | | $2,224.00 | $4,500.00 | $10,043.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,796.00 / $12,991.00 / $17,948.00
| Facility | | $10,796.00 | $12,991.00 | $17,948.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.15 / $1,740.17 / $6,362.00
| Facility | | $849.15 | $1,740.17 | $6,362.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $230.52 / $1,537.78 / $1,537.78
| Facility | AS | $230.52 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,738.00 / $4,463.00 / $12,423.00
| Facility | | $2,738.00 | $4,463.00 | $12,423.00 |