- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $3,467.37 / $10,964.78
| Facility | | $575.44 | $3,467.37 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,888.44 / $12,302.69
| Facility | | $3,388.44 | $5,888.44 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $2,398.83 / $10,964.78
| Facility | | $588.84 | $2,398.83 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $50,118.72
| Facility | | $724.44 | $724.44 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $72.44 / $72.44 / $72.44
| Facility | AS | $72.44 | $72.44 | $72.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $1,584.89
| Facility | | $478.63 | $776.25 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $562.34
| Facility | | $562.34 | $562.34 | $562.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $3,630.78 / $10,715.19
| Facility | | $1,202.26 | $3,630.78 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $50,118.72 / $75,857.76
| Facility | | $446.68 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $4,365.16 / $9,549.93
| Facility | | $2,041.74 | $4,365.16 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $512.86 / $1,949.84
| Facility | | $346.74 | $512.86 | $1,949.84 |