- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $3,235.94 / $11,748.98
| Facility | | $912.01 | $3,235.94 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $9,332.54 / $18,620.87
| Facility | | $5,623.41 | $9,332.54 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $7,762.47 / $12,302.69
| Facility | | $954.99 | $7,762.47 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $8,128.31 / $8,128.31
| Facility | | $891.25 | $8,128.31 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,703.96 / $45,708.82 / $45,708.82
| Facility | | $25,703.96 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | AS | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,348.96 / $4,073.80
| Facility | | $912.01 | $1,348.96 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,288.25 / $2,137.96
| Facility | | $933.25 | $1,288.25 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.96 / $165.96 / $165.96
| Facility | AS | $165.96 | $165.96 | $165.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,317.64 / $17,378.01
| Facility | | $2,630.27 | $8,317.64 | $17,378.01 |