- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $5,463.36 / $24,068.03
| Facility | | $2,318.31 | $5,463.36 | $24,068.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,384.77 / $30,757.36 / $59,494.67
| Facility | | $23,384.77 | $30,757.36 | $59,494.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,763.49 / $21,763.49 / $21,763.49
| Facility | | $21,763.49 | $21,763.49 | $21,763.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $345.92 / $629.15 / $22,001.22
| Facility | | $345.92 | $629.15 | $22,001.22 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $97.26 / $7,800.40 / $7,800.40
| Facility | AS | $97.26 | $7,800.40 | $7,800.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.23 / $1,020.50 / $27,567.08
| Facility | | $699.23 | $1,020.50 | $27,567.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,221.00 / $14,143.00 / $40,166.00
| Facility | | $11,221.00 | $14,143.00 | $40,166.00 |