- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $4,073.80 / $14,454.40
| Facility | | $1,174.90 | $4,073.80 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,370.32 / $9,549.93 / $19,054.61
| Facility | | $5,370.32 | $9,549.93 | $19,054.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $1,412.54 / $1,445.44
| Facility | | $79.43 | $1,412.54 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,918.31 / $6,918.31
| Facility | | $3,630.78 | $6,918.31 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $23,442.29
| Facility | | $54.95 | $56.23 | $23,442.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,344.23 / $2,344.23 / $2,344.23
| Facility | AS | $2,344.23 | $2,344.23 | $2,344.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,318.26 / $1,949.84 / $5,011.87
| Facility | | $1,318.26 | $1,949.84 | $5,011.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $1,862.09 / $3,388.44
| Facility | | $1,412.54 | $1,862.09 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | AS | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $8,128.31 / $16,982.44
| Facility | | $2,630.27 | $8,128.31 | $16,982.44 |