- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,024.27 / $4,818.95 / $11,030.21
| Facility | | $1,024.27 | $4,818.95 | $11,030.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,514.30 / $43,074.16 / $75,989.38
| Facility | | $10,514.30 | $43,074.16 | $75,989.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $438.59 / $505.00 / $23,722.56
| Facility | | $438.59 | $505.00 | $23,722.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $43.55 / $43.55 / $43.55
| Facility | AS | $43.55 | $43.55 | $43.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $429.29 / $571.54 / $841.88
| Facility | | $429.29 | $571.54 | $841.88 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $68.55 / $94.92 / $114.01
| Facility | AS | $68.55 | $94.92 | $114.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,252.00 / $25,508.00 / $43,200.00
| Facility | | $4,252.00 | $25,508.00 | $43,200.00 |