- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $295.12 / $14,454.40
| Facility | | $173.78 | $295.12 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,882.50 / $20,417.38
| Facility | | $9,120.11 | $12,882.50 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $426.58 / $691.83
| Facility | | $371.54 | $426.58 | $691.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $169.82 / $7,244.36 / $14,454.40
| Facility | | $169.82 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $165.96 / $2,818.38 / $9,549.93
| Facility | | $165.96 | $2,818.38 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $181.97 / $354.81 / $588.84
| Professional | | $181.97 | $354.81 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $371.54 / $371.54 / $954.99
| Facility | | $371.54 | $371.54 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $37.15 / $37.15 / $95.50
| Facility | AS | $37.15 | $37.15 | $95.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |