- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,889.94 / $6,827.70 / $14,796.00
| Facility | | $1,889.94 | $6,827.70 | $14,796.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $38,700.57 / $57,418.74 / $75,212.97
| Facility | | $38,700.57 | $57,418.74 | $75,212.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $640.00 / $640.00 / $1,920.98
| Facility | | $640.00 | $640.00 | $1,920.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $190.33 / $190.33 / $190.33
| Facility | AS | $190.33 | $190.33 | $190.33 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,591.08 / $2,051.05 / $2,423.96
| Professional | | $1,591.08 | $2,051.05 | $2,423.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,718.60 / $2,211.23 / $3,263.20
| Facility | | $1,718.60 | $2,211.23 | $3,263.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $270.33 / $342.86 / $604.38
| Facility | AS | $270.33 | $342.86 | $604.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,600.72 / $2,127.46 / $7,094.16
| Facility | | $1,600.72 | $2,127.46 | $7,094.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,621.00 / $25,197.00 / $42,546.00
| Facility | | $7,621.00 | $25,197.00 | $42,546.00 |