- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45.71 / $1,174.90 / $6,456.54
| Facility | | $45.71 | $1,174.90 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $8,511.38 / $18,197.01
| Facility | | $5,128.61 | $8,511.38 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $2,754.23 / $4,365.16
| Facility | | $2,344.23 | $2,754.23 | $4,365.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $7,244.36 / $14,454.40
| Facility | | $1,071.52 | $7,244.36 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,388.44 / $9,549.93
| Facility | | $1,047.13 | $3,388.44 | $9,549.93 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,290.87 / $3,890.45
| Professional | | $1,584.89 | $2,290.87 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $9,772.37 / $9,772.37
| Facility | | $2,344.23 | $9,772.37 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $234.42 / $234.42 / $977.24
| Facility | AS | $234.42 | $234.42 | $977.24 |
- 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 |