- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,467.37 / $8,128.31
| Facility | | $933.25 | $3,467.37 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $11,481.54 / $30,199.52
| Facility | | $4,786.30 | $11,481.54 | $30,199.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,698.24 / $6,165.95
| Facility | | $1,000.00 | $1,698.24 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $50,118.72
| Facility | | $1,202.26 | $1,202.26 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $120.23 / $120.23 / $120.23
| Facility | AS | $120.23 | $120.23 | $120.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $776.25 / $1,819.70
| Facility | | $302.00 | $776.25 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $660.69
| Facility | | $660.69 | $660.69 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,398.83 / $14,125.38
| Facility | | $891.25 | $2,398.83 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $50,118.72 / $75,857.76
| Facility | | $660.69 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $6,456.54 / $16,982.44
| Facility | | $2,454.71 | $6,456.54 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $851.14 / $2,290.87
| Facility | | $575.44 | $851.14 | $2,290.87 |