- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,318.31 / $6,048.00 / $62,074.17
| Facility | | $2,318.31 | $6,048.00 | $62,074.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $22,881.23 / $31,009.94 / $58,213.58
| Facility | | $22,881.23 | $31,009.94 | $58,213.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $779.25 / $1,363.69 / $45,111.12
| Facility | | $779.25 | $1,363.69 | $45,111.12 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $13,888.08 / $13,888.08 / $13,888.08
| Facility | AS | $13,888.08 | $13,888.08 | $13,888.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.44 / $2,313.11 / $51,664.54
| Facility | | $1,548.44 | $2,313.11 | $51,664.54 |
- 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 |