- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $5,888.44 / $15,488.17
| Facility | | $1,096.48 | $5,888.44 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,220.18 / $26,302.68
| Facility | | $5,011.87 | $11,220.18 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $2,630.27 / $12,302.69
| Facility | | $1,148.15 | $2,630.27 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,380.38 / $50,118.72
| Facility | | $34.67 | $1,380.38 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Facility | AS | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,659.59 / $2,951.21
| Facility | | $870.96 | $1,659.59 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $10,964.78 / $17,782.79
| Facility | | $3,548.13 | $10,964.78 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $50,118.72 / $75,857.76
| Facility | | $933.25 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $7,762.47 / $18,620.87
| Facility | | $2,511.89 | $7,762.47 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $933.25 / $2,754.23
| Facility | | $660.69 | $933.25 | $2,754.23 |