- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,248.07 / $12,022.64
| Facility | | $1,949.84 | $5,248.07 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $37,153.52
| Facility | | $2,290.87 | $2,290.87 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,754.23 / $50,118.72
| Facility | | $34.67 | $2,754.23 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $275.42 / $275.42 / $275.42
| Facility | AS | $275.42 | $275.42 | $275.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,398.83 / $6,165.95
| Facility | | $1,698.24 | $2,398.83 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $1,513.56
| Facility | | $1,513.56 | $1,513.56 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $50,118.72 / $75,857.76
| Facility | | $1,659.59 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,606.93 / $17,782.79
| Facility | | $2,454.71 | $6,606.93 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,691.53 / $6,918.31
| Facility | | $1,318.26 | $2,691.53 | $6,918.31 |