- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,073.80 / $14,125.38
| Facility | | $1,071.52 | $4,073.80 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $3,890.45 / $7,762.47
| Facility | | $1,995.26 | $3,890.45 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Facility | | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $33,884.42 / $33,884.42
| Facility | | $3,890.45 | $33,884.42 | $33,884.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Facility | AS | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.88 / $549.54 / $6,918.31
| Facility | | $239.88 | $549.54 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $218.78 / $338.84 / $588.84
| Facility | | $218.78 | $338.84 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $154.88 / $1,047.13 / $2,691.53
| Facility | | $154.88 | $1,047.13 | $2,691.53 |