- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,862.09 / $14,454.40
| Facility | | $1,096.48 | $1,862.09 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,882.50 / $23,442.29
| Facility | | $9,120.11 | $12,882.50 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,691.53 / $4,365.16
| Facility | | $2,344.23 | $2,691.53 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $5,128.61 / $9,549.93
| Facility | | $1,071.52 | $5,128.61 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $10,715.19 / $19,952.62
| Facility | | $1,047.13 | $10,715.19 | $19,952.62 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,202.26 / $2,290.87 / $3,630.78
| Professional | | $1,202.26 | $2,290.87 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $16,982.44 / $16,982.44
| Facility | | $2,344.23 | $16,982.44 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $234.42 / $234.42 / $1,698.24
| Facility | AS | $234.42 | $234.42 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,128.31 / $16,218.10 / $21,379.62
| Facility | | $8,128.31 | $16,218.10 | $21,379.62 |