- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $3,548.13 / $10,964.78
| Facility | | $263.03 | $3,548.13 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $7,762.47 / $13,803.84
| Facility | | $3,890.45 | $7,762.47 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $263.03 / $263.03 / $10,964.78
| Facility | | $263.03 | $263.03 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $323.59 / $14,454.40
| Facility | | $34.67 | $323.59 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $32.36 / $32.36 / $32.36
| Facility | AS | $32.36 | $32.36 | $32.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $181.97 / $251.19 / $660.69
| Facility | | $181.97 | $251.19 | $660.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $173.78 / $173.78
| Facility | | $173.78 | $173.78 | $173.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $186.21 / $50,118.72 / $75,857.76
| Facility | | $186.21 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,754.23 / $5,011.87
| Facility | | $831.76 | $2,754.23 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $151.36 / $218.78 / $562.34
| Facility | | $151.36 | $218.78 | $562.34 |