- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $4,168.69 / $10,964.78
| Facility | | $602.56 | $4,168.69 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $2,398.83 / $10,964.78
| Facility | | $602.56 | $2,398.83 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $741.31 / $50,118.72
| Facility | | $741.31 | $741.31 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $74.13 / $74.13 / $74.13
| Facility | AS | $74.13 | $74.13 | $74.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $724.44 / $1,584.89
| Facility | | $489.78 | $724.44 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $416.87
| Facility | | $416.87 | $416.87 | $416.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $50,118.72 / $75,857.76
| Facility | | $478.63 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $5,128.61 / $11,481.54
| Facility | | $2,344.23 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $524.81 / $2,238.72
| Facility | | $354.81 | $524.81 | $2,238.72 |