- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.64 / $9,706.00 / $14,213.60
| Facility | | $1,585.64 | $9,706.00 | $14,213.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $24,036.99
| Facility | | $606.10 | $606.10 | $24,036.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,585.64 / $2,014.80 / $2,953.87
| Facility | | $1,585.64 | $2,014.80 | $2,953.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $282.07 / $283.26 / $501.70
| Facility | AS | $282.07 | $283.26 | $501.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $13,946.00 / $21,454.00
| Facility | | $4,317.00 | $13,946.00 | $21,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,809.54 / $69,336.13 / $79,437.95
| Facility | | $16,809.54 | $69,336.13 | $79,437.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $354.59 / $4,526.85 / $7,529.59
| Facility | AS | $354.59 | $4,526.85 | $7,529.59 |