- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $281.84 / $14,454.40
| Facility | | $173.78 | $281.84 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,964.78 / $18,197.01
| Facility | | $6,606.93 | $10,964.78 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $407.38 / $660.69
| Facility | | $354.81 | $407.38 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $177.83 / $7,244.36 / $13,489.63
| Facility | | $177.83 | $7,244.36 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $162.18 / $2,818.38 / $7,943.28
| Facility | | $162.18 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $218.78 / $346.74 / $501.19
| Professional | | $218.78 | $346.74 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $354.81 / $1,288.25 / $1,288.25
| Facility | | $354.81 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $35.48 / $35.48 / $91.20
| Facility | AS | $35.48 | $35.48 | $91.20 |
- 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 |