- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,715.35 / $10,964.78
| Facility | | $1,819.70 | $3,715.35 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $8,511.38 / $16,595.87
| Facility | | $4,466.84 | $8,511.38 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $2,238.72 / $37,153.52
| Facility | | $2,238.72 | $2,238.72 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,691.53 / $50,118.72
| Facility | | $34.67 | $2,691.53 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | AS | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,041.74 / $6,025.60
| Facility | | $1,659.59 | $2,041.74 | $6,025.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $50,118.72 / $75,857.76
| Facility | | $1,659.59 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,265.80 / $9,332.54
| Facility | | $1,513.56 | $4,265.80 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,698.24 / $5,128.61
| Facility | | $1,258.93 | $1,698.24 | $5,128.61 |