- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $4,677.35 / $12,882.50
| Facility | | $1,096.48 | $4,677.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $7,244.36 / $15,488.17
| Facility | | $3,548.13 | $7,244.36 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $3,548.13 / $3,548.13
| Facility | | $380.19 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $3,715.35 / $4,073.80
| Facility | | $707.95 | $3,715.35 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $70.79 / $70.79 / $70.79
| Facility | AS | $70.79 | $70.79 | $70.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $16,218.10 / $16,218.10
| Facility | | $54.95 | $16,218.10 | $16,218.10 |
- 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
- $389.05 / $512.86 / $1,047.13
| Facility | | $389.05 | $512.86 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $524.81 / $933.25
| Facility | | $398.11 | $524.81 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $7,762.47 / $15,488.17
| Facility | | $2,570.40 | $7,762.47 | $15,488.17 |