- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,570.88 / $8,128.31
| Facility | | $2,570.40 | $4,570.88 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $6,025.60 / $50,118.72
| Facility | | $1,348.96 | $6,025.60 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | AS | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $1,949.84 / $6,309.57
| Facility | | $954.99 | $1,949.84 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,230.27 / $7,079.46
| Facility | | $562.34 | $1,230.27 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $5,888.44 / $15,488.17
| Facility | | $851.14 | $5,888.44 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $6,456.54
| Facility | | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $6,025.60 / $50,118.72
| Facility | | $1,348.96 | $6,025.60 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,621.81 / $1,621.81 / $1,621.81
| Facility | AS | $1,621.81 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $6,025.60 / $15,488.17
| Facility | | $1,698.24 | $6,025.60 | $15,488.17 |