- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $776.25 / $14,454.40
| Facility | | $478.63 | $776.25 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,882.50 / $18,197.01 / $28,840.32
| Facility | | $12,882.50 | $18,197.01 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,122.02 / $1,819.70
| Facility | | $977.24 | $1,122.02 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $446.68 / $7,244.36 / $13,489.63
| Facility | | $446.68 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $2,818.38 / $7,943.28
| Facility | | $416.87 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $602.56 / $954.99 / $1,348.96
| Professional | | $602.56 | $954.99 | $1,348.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,454.71 / $2,454.71
| Facility | | $977.24 | $2,454.71 | $2,454.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $97.72 / $97.72 / $245.47
| Facility | AS | $97.72 | $97.72 | $245.47 |
- 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 |