- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $4,365.16 / $8,709.64
| Facility | | $676.08 | $4,365.16 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $7,585.78 / $57,543.99
| Facility | | $6,456.54 | $7,585.78 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $707.95 / $707.95
| Facility | | $707.95 | $707.95 | $707.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $70.79 / $70.79 / $70.79
| Facility | AS | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,890.45 / $5,623.41
| Facility | | $2,041.74 | $3,890.45 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $3,890.45 / $8,317.64
| Facility | | $660.69 | $3,890.45 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $851.14
| Facility | | $416.87 | $416.87 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $407.38 / $676.08 / $758.58
| Facility | | $407.38 | $676.08 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $3,162.28 / $5,888.44
| Facility | | $1,659.59 | $3,162.28 | $5,888.44 |