- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $835.43 / $3,908.01 / $13,841.56
| Facility | | $835.43 | $3,908.01 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,024.04 / $19,760.71 / $38,223.60
| Facility | | $15,024.04 | $19,760.71 | $38,223.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,739.18 / $7,739.18 / $7,739.18
| Facility | | $7,739.18 | $7,739.18 | $7,739.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.94 / $1,179.04 / $3,168.78
| Facility | | $489.94 | $1,179.04 | $3,168.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $205.58 / $205.58 / $205.58
| Facility | AS | $205.58 | $205.58 | $205.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $988.36 / $1,879.79 / $9,287.01
| Facility | | $988.36 | $1,879.79 | $9,287.01 |
- 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 |