- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $3,090.30 / $9,332.54
| Facility | | $1,258.93 | $3,090.30 | $9,332.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $8,511.38 / $16,595.87
| Facility | | $4,570.88 | $8,511.38 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,513.56 / $37,153.52
| Facility | | $1,513.56 | $1,513.56 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,862.09 / $50,118.72
| Facility | | $34.67 | $1,862.09 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.21 / $186.21 / $186.21
| Facility | AS | $186.21 | $186.21 | $186.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,288.25 / $3,801.89
| Facility | | $933.25 | $1,288.25 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $50,118.72 / $75,857.76
| Facility | | $1,096.48 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $7,762.47 / $18,197.01
| Facility | | $2,818.38 | $7,762.47 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,148.15 / $3,162.28
| Facility | | $870.96 | $1,148.15 | $3,162.28 |