- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,931.43 / $5,128.00 / $27,982.24
| Facility | | $1,931.43 | $5,128.00 | $27,982.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,750.23 / $36,469.56 / $71,345.31
| Facility | | $6,750.23 | $36,469.56 | $71,345.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,721.56 / $4,526.82 / $4,526.82
| Facility | AS | $2,721.56 | $4,526.82 | $4,526.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $870.49 / $19,943.82
| Facility | | $714.97 | $870.49 | $19,943.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,093.58 / $2,323.62 / $15,822.73
| Facility | | $1,093.58 | $2,323.62 | $15,822.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,559.61 / $2,156.73 / $2,284.03
| Facility | | $1,559.61 | $2,156.73 | $2,284.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,500.79 / $1,557.91 / $20,269.31
| Facility | | $1,500.79 | $1,557.91 | $20,269.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,749.60 / $37,275.87 / $71,345.31
| Facility | | $24,749.60 | $37,275.87 | $71,345.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $3,129.00 / $11,941.00
| Facility | | $2,155.00 | $3,129.00 | $11,941.00 |