- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,066.30 / $4,884.93 / $14,570.05
| Facility | | $1,066.30 | $4,884.93 | $14,570.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $11,851.00 / $26,582.19
| Facility | | $8,639.91 | $11,851.00 | $26,582.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.44 / $1,154.44 / $1,154.44
| Facility | | $1,154.44 | $1,154.44 | $1,154.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.57 / $114.57 / $114.57
| Facility | AS | $114.57 | $114.57 | $114.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,126.39 / $23,453.40 / $32,020.43
| Facility | | $6,126.39 | $23,453.40 | $32,020.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,013.00 / $5,281.00 / $10,915.00
| Facility | | $1,013.00 | $5,281.00 | $10,915.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.44 / $1,154.44 / $1,154.44
| Facility | | $1,154.44 | $1,154.44 | $1,154.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.57 / $114.57 / $114.57
| Facility | AS | $114.57 | $114.57 | $114.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $995.43 / $995.43 / $1,152.33
| Facility | | $995.43 | $995.43 | $1,152.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |