- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,083.01 / $8,355.33 / $19,276.96
| Facility | | $3,083.01 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,810.78 / $8,958.04 / $17,327.75
| Facility | | $6,810.78 | $8,958.04 | $17,327.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $471.79 / $838.46 / $4,217.00
| Facility | | $471.79 | $838.46 | $4,217.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $131.75 / $497.27 / $497.27
| Facility | AS | $131.75 | $497.27 | $497.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $938.00 / $1,264.06 / $1,978.64
| Facility | | $938.00 | $1,264.06 | $1,978.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |