- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $3,715.35 / $13,489.63
| Facility | | $977.24 | $3,715.35 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $275.42 / $467.74 / $2,511.89
| Facility | | $275.42 | $467.74 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $245.47 / $245.47
| Facility | | $218.78 | $245.47 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $10,964.78 / $12,302.69
| Facility | | $10,964.78 | $10,964.78 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $1,584.89
| Facility | | $54.95 | $56.23 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | AS | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $512.86 / $5,248.07
| Facility | | $263.03 | $512.86 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.19 / $346.74 / $602.56
| Facility | | $251.19 | $346.74 | $602.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $14,791.08 / $31,622.78
| Facility | | $6,606.93 | $14,791.08 | $31,622.78 |