- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $257.04 / $14,454.40
| Facility | | $125.89 | $257.04 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,754.40 / $12,589.25 / $16,218.10
| Facility | | $5,754.40 | $12,589.25 | $16,218.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $380.19 / $616.60
| Facility | | $323.59 | $380.19 | $616.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $125.89 / $257.04 / $5,754.40
| Facility | | $125.89 | $257.04 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $128.82 / $263.03 / $1,778.28
| Facility | | $128.82 | $263.03 | $1,778.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $275.42 / $416.87
| Professional | | $181.97 | $275.42 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $4,073.80 / $4,073.80
| Facility | | $323.59 | $4,073.80 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $32.36 / $32.36 / $83.18
| Facility | AS | $32.36 | $32.36 | $83.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,584.89 / $2,137.96
| Facility | | $1,023.29 | $1,584.89 | $2,137.96 |