- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,461.16 / $11,467.05 / $21,526.57
| Facility | | $8,461.16 | $11,467.05 | $21,526.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,018.81 / $3,073.26 / $7,856.00
| Facility | | $2,018.81 | $3,073.26 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $956.73 / $956.73 / $956.73
| Facility | AS | $956.73 | $956.73 | $956.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.68 / $4,599.68 / $5,894.57
| Facility | | $3,548.68 | $4,599.68 | $5,894.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |