- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,227.70 / $7,993.00 / $21,776.24
| Facility | | $1,227.70 | $7,993.00 | $21,776.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,397.92 / $4,397.92 / $6,284.08
| Facility | | $4,397.92 | $4,397.92 | $6,284.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,077.04
| Facility | | $606.10 | $606.10 | $8,077.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.54 / $1,216.22 / $1,764.50
| Facility | | $884.54 | $1,216.22 | $1,764.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $153.02 / $196.84 / $279.87
| Facility | AS | $153.02 | $196.84 | $279.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,407.04 / $26,542.00 / $26,693.15
| Facility | | $3,407.04 | $26,542.00 | $26,693.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $207.43 / $1,521.14 / $2,530.14
| Facility | AS | $207.43 | $1,521.14 | $2,530.14 |