- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $23,483.17
| Facility | | $4,241.22 | $10,431.19 | $23,483.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,065.02 / $1,917.04 / $9,696.00
| Facility | | $1,065.02 | $1,917.04 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $299.73 / $1,887.52 / $1,887.52
| Facility | AS | $299.73 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,149.38 / $2,916.55 / $6,616.19
| Facility | | $2,149.38 | $2,916.55 | $6,616.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $21,846.00
| Facility | | $6,777.00 | $8,220.00 | $21,846.00 |