- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $5,248.07 / $12,302.69
| Facility | | $1,174.90 | $5,248.07 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,943.28 / $22,908.68
| Facility | | $4,073.80 | $7,943.28 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,202.26 / $12,302.69
| Facility | | $1,202.26 | $1,202.26 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,412.54 / $50,118.72
| Facility | | $34.67 | $1,412.54 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Facility | AS | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,445.44 / $2,884.03
| Facility | | $870.96 | $1,445.44 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $6,456.54 / $8,317.64
| Facility | | $2,041.74 | $6,456.54 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $50,118.72 / $75,857.76
| Facility | | $851.14 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.83 / $5,128.61 / $12,302.69
| Facility | | $2,398.83 | $5,128.61 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $954.99 / $2,754.23
| Facility | | $691.83 | $954.99 | $2,754.23 |