- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $22,908.68
| Facility | | $2,238.72 | $4,677.35 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,585.78 / $32,359.37
| Facility | | $3,890.45 | $7,585.78 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $37,153.52
| Facility | | $2,754.23 | $2,754.23 | $37,153.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $27,542.29 / $38,904.51
| Facility | | $3,388.44 | $27,542.29 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $338.84 / $338.84 / $338.84
| Facility | AS | $338.84 | $338.84 | $338.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $2,398.83 / $38,904.51
| Facility | | $1,698.24 | $2,398.83 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $1,819.70 / $1,819.70
| Facility | | $1,819.70 | $1,819.70 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $10,715.19 / $11,481.54
| Facility | | $10,715.19 | $10,715.19 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $50,118.72 / $75,857.76
| Facility | | $4,786.30 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $5,011.87 / $38,904.51
| Facility | | $1,513.56 | $5,011.87 | $38,904.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,290.87 / $6,025.60
| Facility | | $1,584.89 | $2,290.87 | $6,025.60 |