- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,073.80 / $11,748.98
| Facility | | $1,096.48 | $4,073.80 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,995.26 / $6,606.93
| Facility | | $1,174.90 | $1,995.26 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $1,023.29 / $1,096.48
| Facility | | $1,023.29 | $1,023.29 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $1,905.46 / $2,511.89
| Facility | | $891.25 | $1,905.46 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- 22
- Low / Median / High Price
- $2,290.87 / $2,290.87 / $2,290.87
| Facility | 22 | $2,290.87 | $2,290.87 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $190.55 / $190.55 / $190.55
| Facility | AS | $190.55 | $190.55 | $190.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $8,912.51
| Facility | | $2,818.38 | $2,818.38 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | AS | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,548.82 / $4,677.35
| Facility | | $1,047.13 | $1,548.82 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $1,445.44 / $2,511.89
| Facility | | $1,071.52 | $1,445.44 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,011.87 / $10,964.78
| Facility | | $1,698.24 | $5,011.87 | $10,964.78 |