- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $21,899.37
| Facility | | $4,241.22 | $10,431.19 | $21,899.37 |
- 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
- $1,436.51 / $2,585.71 / $9,696.00
| Facility | | $1,436.51 | $2,585.71 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $402.97 / $770.53 / $770.53
| Facility | AS | $402.97 | $770.53 | $770.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.45 / $3,608.99 / $5,100.53
| Facility | | $1,862.45 | $3,608.99 | $5,100.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |