- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $3,715.35 / $13,489.63
| Facility | | $1,096.48 | $3,715.35 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $7,413.10 / $14,791.08
| Facility | | $4,265.80 | $7,413.10 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,348.96 / $4,786.30
| Facility | | $346.74 | $1,348.96 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $4,897.79 / $4,897.79
| Facility | | $933.25 | $4,897.79 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $13,803.84
| Facility | | $54.95 | $56.23 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,380.38 / $1,380.38 / $1,380.38
| Facility | AS | $1,380.38 | $1,380.38 | $1,380.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,584.89 / $5,370.32
| Facility | | $977.24 | $1,584.89 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $1,380.38 / $2,344.23
| Facility | | $977.24 | $1,380.38 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,606.93 / $13,803.84
| Facility | | $2,187.76 | $6,606.93 | $13,803.84 |