- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,413.82 / $7,439.00 / $22,891.63
| Facility | | $1,413.82 | $7,439.00 | $22,891.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,790.43 / $5,790.43 / $5,874.92
| Facility | | $5,790.43 | $5,790.43 | $5,874.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $1,182.48 / $24,536.72
| Facility | | $1,182.48 | $1,182.48 | $24,536.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,413.82 / $1,850.03 / $2,812.68
| Facility | | $1,413.82 | $1,850.03 | $2,812.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $209.86 / $259.00 / $447.33
| Facility | AS | $209.86 | $259.00 | $447.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,153.00 / $21,463.00 / $29,047.00
| Facility | | $8,153.00 | $21,463.00 | $29,047.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,811.68 / $70,777.66 / $81,089.45
| Facility | | $10,811.68 | $70,777.66 | $81,089.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $327.31 / $4,620.97 / $7,686.13
| Facility | AS | $327.31 | $4,620.97 | $7,686.13 |