- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,534.21 / $8,477.27 / $20,928.72
| Facility | | $1,534.21 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,534.21 / $2,684.87 / $4,406.00
| Facility | | $1,534.21 | $2,684.87 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $431.50 / $827.45 / $827.45
| Facility | AS | $431.50 | $827.45 | $827.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,993.71 / $3,869.77 / $5,509.74
| Facility | | $1,993.71 | $3,869.77 | $5,509.74 |
- 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 |