- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $5,011.87 / $14,454.40
| Facility | | $1,230.27 | $5,011.87 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $13,489.63 / $25,703.96
| Facility | | $6,606.93 | $13,489.63 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $9,120.11 / $19,054.61
| Facility | | $5,011.87 | $9,120.11 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $707.95 / $11,748.98 / $11,748.98
| Facility | | $707.95 | $11,748.98 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,079.46 / $7,079.46 / $7,079.46
| Facility | | $7,079.46 | $7,079.46 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $27,542.29
| Facility | | $2,818.38 | $2,818.38 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,754.23 / $2,754.23 / $2,754.23
| Facility | AS | $2,754.23 | $2,754.23 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,137.96 / $10,232.93
| Facility | | $776.25 | $2,137.96 | $10,232.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,047.13 / $1,819.70
| Facility | | $724.44 | $1,047.13 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,709.64 / $17,782.79
| Facility | | $2,630.27 | $8,709.64 | $17,782.79 |