- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.13 / $8,002.00 / $15,906.50
| Facility | | $1,304.13 | $8,002.00 | $15,906.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $15,423.54
| Facility | | $748.70 | $748.70 | $15,423.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,304.13 / $1,741.19 / $2,587.58
| Facility | | $1,304.13 | $1,741.19 | $2,587.58 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $216.30 / $294.42 / $412.63
| Facility | AS | $216.30 | $294.42 | $412.63 |
- 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
- $4,934.20 / $44,490.14 / $50,972.05
| Facility | | $4,934.20 | $44,490.14 | $50,972.05 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $300.51 / $2,904.70 / $4,831.43
| Facility | AS | $300.51 | $2,904.70 | $4,831.43 |