- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $4,677.35 / $16,982.44
| Facility | | $1,258.93 | $4,677.35 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,317.64 / $13,489.63
| Facility | | $5,011.87 | $8,317.64 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,698.24 / $2,884.03
| Facility | | $1,479.11 | $1,698.24 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,148.15 / $8,317.64
| Facility | | $562.34 | $1,148.15 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,348.96 / $11,220.18
| Facility | | $562.34 | $1,348.96 | $11,220.18 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $831.76 / $1,258.93 / $1,905.46
| Professional | | $831.76 | $1,258.93 | $1,905.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $6,025.60 / $8,912.51
| Facility | | $3,235.94 | $6,025.60 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $602.56 / $602.56 / $891.25
| Facility | AS | $602.56 | $602.56 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,232.93 / $12,589.25
| Facility | | $6,606.93 | $10,232.93 | $12,589.25 |