- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,244.75 / $6,384.00 / $21,137.45
| Facility | | $1,244.75 | $6,384.00 | $21,137.45 |
- 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 / $15,032.61
| Facility | | $606.10 | $606.10 | $15,032.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.75 / $1,486.42 / $2,197.57
| Facility | | $1,098.75 | $1,486.42 | $2,197.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.06 / $260.08 / $347.64
| Facility | AS | $186.06 | $260.08 | $347.64 |
- 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
- $4,182.84 / $43,362.45 / $49,680.10
| Facility | | $4,182.84 | $43,362.45 | $49,680.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $255.14 / $2,831.07 / $4,708.97
| Facility | AS | $255.14 | $2,831.07 | $4,708.97 |