- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,316.83 / $14,964.46 / $30,387.66
| Facility | | $1,316.83 | $14,964.46 | $30,387.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,886.41 / $16,351.48 / $31,278.54
| Facility | | $9,886.41 | $16,351.48 | $31,278.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $924.53 / $1,537.78 / $1,537.78
| Facility | AS | $924.53 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,066.66 / $4,066.66 / $6,775.01
| Facility | | $4,066.66 | $4,066.66 | $6,775.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $887.04 / $1,574.51 / $12,028.17
| Facility | | $887.04 | $1,574.51 | $12,028.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,026.06 / $1,355.41 / $1,441.17
| Facility | | $1,026.06 | $1,355.41 | $1,441.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.10 / $983.01 / $2,429.53
| Facility | | $958.10 | $983.01 | $2,429.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,603.20 / $16,342.14 / $31,278.54
| Facility | | $10,603.20 | $16,342.14 | $31,278.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $4,686.00 / $20,708.00
| Facility | | $3,028.00 | $4,686.00 | $20,708.00 |