- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,673.00 / $10,469.20 / $28,964.66
| Facility | | $4,673.00 | $10,469.20 | $28,964.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,956.85 / $38,120.97 / $105,762.55
| Facility | | $3,956.85 | $38,120.97 | $105,762.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,868.33 / $32,868.33 / $42,236.41
| Facility | | $32,868.33 | $32,868.33 | $42,236.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.70 / $1,116.85 / $1,899.23
| Facility | | $852.70 | $1,116.85 | $1,899.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $154.31 / $156.36 / $220.26
| Facility | AS | $154.31 | $156.36 | $220.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,252.00 / $26,459.00 / $63,302.00
| Facility | | $4,252.00 | $26,459.00 | $63,302.00 |