- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,733.00 / $10,122.46 / $27,982.24
| Facility | | $1,733.00 | $10,122.46 | $27,982.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,500.00 / $37,275.87 / $71,345.31
| Facility | | $11,500.00 | $37,275.87 | $71,345.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $3,012.55 / $5,010.81 / $5,010.81
| Facility | AS | $3,012.55 | $5,010.81 | $5,010.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,005.16 / $1,223.70 / $22,076.17
| Facility | | $1,005.16 | $1,223.70 | $22,076.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,100.41 / $2,279.82 / $17,514.47
| Facility | | $1,100.41 | $2,279.82 | $17,514.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,464.61 / $2,003.30 / $2,101.79
| Facility | | $1,464.61 | $2,003.30 | $2,101.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.88 / $1,433.61 / $24,944.87
| Facility | | $1,393.88 | $1,433.61 | $24,944.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,215.17 / $37,297.19 / $71,345.31
| Facility | | $27,215.17 | $37,297.19 | $71,345.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |