- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $190.55 / $407.38 / $14,454.40
| Facility | | $190.55 | $407.38 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,882.50 / $22,387.21
| Facility | | $9,120.11 | $12,882.50 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $588.84 / $933.25
| Facility | | $501.19 | $588.84 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $6,918.31 / $13,489.63
| Facility | | $218.78 | $6,918.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $2,691.53 / $7,943.28
| Facility | | $218.78 | $2,691.53 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $251.19 / $489.78 / $851.14
| Professional | | $251.19 | $489.78 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $512.86 / $1,288.25 / $1,288.25
| Facility | | $512.86 | $1,288.25 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $51.29 / $51.29 / $128.82
| Facility | AS | $51.29 | $51.29 | $128.82 |
- 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 |