- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $20,892.96 / $35,481.34
| Facility | | $1,202.26 | $20,892.96 | $35,481.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,120.11 / $12,882.50 / $22,908.68
| Facility | | $9,120.11 | $12,882.50 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $3,548.13 / $5,754.40
| Facility | | $3,090.30 | $3,548.13 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $7,079.46 / $13,489.63
| Facility | | $1,318.26 | $7,079.46 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $2,818.38 / $7,943.28
| Facility | | $1,318.26 | $2,818.38 | $7,943.28 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,754.23 / $4,677.35
| Professional | | $1,412.54 | $2,754.23 | $4,677.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $10,964.78 / $10,964.78
| Facility | | $3,090.30 | $10,964.78 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $309.03 / $309.03 / $1,096.48
| Facility | AS | $309.03 | $309.03 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $6,165.95 / $19,498.45
| Facility | | $2,290.87 | $6,165.95 | $19,498.45 |