- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.55 / $8,117.28 / $11,244.87
| Facility | | $841.55 | $8,117.28 | $11,244.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $15,070.92
| Facility | | $748.70 | $748.70 | $15,070.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $841.55 / $1,181.75 / $1,745.48
| Facility | | $841.55 | $1,181.75 | $1,745.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.88 / $206.29 / $266.27
| Facility | AS | $147.88 | $206.29 | $266.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $14,893.00 / $22,265.00
| Facility | | $4,317.00 | $14,893.00 | $22,265.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,835.88 / $43,472.95 / $49,806.70
| Facility | | $4,835.88 | $43,472.95 | $49,806.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $195.66 / $2,838.29 / $4,720.97
| Facility | AS | $195.66 | $2,838.29 | $4,720.97 |