- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.70 / $1,212.43 / $4,608.50
| Facility | | $464.70 | $1,212.43 | $4,608.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,510.35 / $4,510.35 / $4,576.17
| Facility | | $4,510.35 | $4,510.35 | $4,576.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $6,025.59
| Facility | | $530.04 | $530.04 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.86 / $945.38 / $1,455.79
| Facility | | $598.86 | $945.38 | $1,455.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.08 / $132.72 / $221.15
| Facility | AS | $122.08 | $132.72 | $221.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $14,893.00 / $22,265.00
| Facility | | $4,317.00 | $14,893.00 | $22,265.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,845.60 / $3,118.33 / $16,394.00
| Facility | | $2,845.60 | $3,118.33 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $159.78 / $311.83 / $311.83
| Facility | AS | $159.78 | $311.83 | $311.83 |