- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,548.13 / $10,964.78
| Facility | | $831.76 | $3,548.13 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $8,709.64 / $15,848.93
| Facility | | $3,235.94 | $8,709.64 | $15,848.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $6,309.57 / $12,022.64
| Facility | | $812.83 | $6,309.57 | $12,022.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $6,165.95 / $6,165.95
| Facility | | $602.56 | $6,165.95 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $45,708.82 / $45,708.82
| Facility | | $19,952.62 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | AS | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,023.29 / $5,248.07
| Facility | | $660.69 | $1,023.29 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.65 / $891.25 / $1,445.44
| Facility | | $645.65 | $891.25 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.20 / $112.20 / $112.20
| Facility | AS | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,918.31 / $14,125.38
| Facility | | $2,187.76 | $6,918.31 | $14,125.38 |