- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $3,801.89 / $9,120.11
| Facility | | $776.25 | $3,801.89 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,481.54 / $26,302.68
| Facility | | $5,011.87 | $11,481.54 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $616.60 / $2,630.27 / $16,595.87
| Facility | | $616.60 | $2,630.27 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $724.44 / $50,118.72
| Facility | | $34.67 | $724.44 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $72.44 / $72.44 / $72.44
| Facility | AS | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $457.09 / $630.96 / $1,513.56
| Facility | | $457.09 | $630.96 | $1,513.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $50,118.72 / $75,857.76
| Facility | | $3,235.94 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,606.93 / $19,498.45
| Facility | | $2,454.71 | $6,606.93 | $19,498.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $741.31 / $1,023.29
| Facility | | $354.81 | $741.31 | $1,023.29 |