- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $3,311.31 / $5,623.41
| Facility | | $724.44 | $3,311.31 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,677.35 / $19,054.61
| Facility | | $56.23 | $4,677.35 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | AS | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $562.34 / $1,288.25
| Facility | | $562.34 | $562.34 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $954.99 / $7,079.46
| Facility | | $446.68 | $954.99 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $6,918.31 / $15,488.17
| Facility | | $2,570.40 | $6,918.31 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,488.17 / $15,488.17 / $15,488.17
| Facility | | $15,488.17 | $15,488.17 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $56.23 / $4,677.35 / $19,054.61
| Facility | | $56.23 | $4,677.35 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | AS | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,244.36 / $16,595.87
| Facility | | $2,570.40 | $7,244.36 | $16,595.87 |