- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.22 / $5,873.35 / $27,982.24
| Facility | | $922.22 | $5,873.35 | $27,982.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,851.21 / $19,823.93 / $38,781.51
| Facility | | $8,851.21 | $19,823.93 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,545.62 / $2,570.85 / $2,570.85
| Facility | AS | $1,545.62 | $2,570.85 | $2,570.85 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $625.25 / $761.81 / $11,326.40
| Facility | | $625.25 | $761.81 | $11,326.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $702.96 / $1,445.65 / $9,932.87
| Facility | | $702.96 | $1,445.65 | $9,932.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $966.77 / $1,338.66 / $1,439.16
| Facility | | $966.77 | $1,338.66 | $1,439.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.55 / $981.64 / $8,851.21
| Facility | | $958.55 | $981.64 | $8,851.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,146.66 / $20,262.22 / $38,781.51
| Facility | | $13,146.66 | $20,262.22 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |