- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,548.82 / $3,235.94 / $14,454.40
| Facility | | $1,548.82 | $3,235.94 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $17,378.01 / $29,512.09
| Facility | | $12,882.50 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $4,786.30 / $7,585.78
| Facility | | $4,073.80 | $4,786.30 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,235.94 / $10,471.29
| Facility | | $1,584.89 | $3,235.94 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,630.78 / $16,982.44
| Facility | | $1,584.89 | $3,630.78 | $16,982.44 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,467.37 / $5,248.07
| Professional | | $2,290.87 | $3,467.37 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,113.11 / $33,113.11 / $50,118.72
| Facility | | $33,113.11 | $33,113.11 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- 52
- Low / Median / High Price
- $26,302.68 / $26,302.68 / $39,810.72
| Facility | 52 | $26,302.68 | $26,302.68 | $39,810.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $3,311.31 / $3,311.31 / $5,011.87
| Facility | AS | $3,311.31 | $3,311.31 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,585.78 / $13,182.57 / $28,840.32
| Facility | | $7,585.78 | $13,182.57 | $28,840.32 |