- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,031.01 / $10,431.19 / $21,899.37
| Facility | | $1,031.01 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $963.97 / $1,735.15 / $7,441.00
| Facility | | $963.97 | $1,735.15 | $7,441.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.78 / $490.02 / $490.02
| Facility | AS | $194.78 | $490.02 | $490.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,237.90 / $1,570.59 / $2,529.48
| Facility | | $1,237.90 | $1,570.59 | $2,529.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |