- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $6,025.60 / $10,471.29
| Facility | | $1,071.52 | $6,025.60 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,125.38 / $14,125.38 / $57,543.99
| Facility | | $14,125.38 | $14,125.38 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $1,778.28 / $1,778.28
| Facility | | $1,778.28 | $1,778.28 | $1,778.28 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,137.96 / $2,137.96 / $2,137.96
| Facility | 22 | $2,137.96 | $2,137.96 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $177.83 / $177.83 / $177.83
| Facility | AS | $177.83 | $177.83 | $177.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $14,125.38 / $75,857.76
| Facility | | $4,168.69 | $14,125.38 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $5,128.61 / $10,232.93
| Facility | | $1,071.52 | $5,128.61 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $2,137.96
| Facility | | $1,445.44 | $1,445.44 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $691.83 / $1,023.29
| Facility | | $691.83 | $691.83 | $1,023.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $5,495.41 / $39,810.72
| Facility | | $2,454.71 | $5,495.41 | $39,810.72 |