- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $3,630.78 / $6,456.54
| Facility | | $1,862.09 | $3,630.78 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $32,359.37
| Facility | | $501.19 | $1,862.09 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $363.08 / $363.08 / $363.08
| Facility | AS | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $812.83 / $7,079.46
| Facility | | $208.93 | $812.83 | $7,079.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $14,454.40
| Facility | | $630.96 | $2,041.74 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $1,949.84
| Facility | | $1,949.84 | $1,949.84 | $1,949.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $501.19 / $1,862.09 / $32,359.37
| Facility | | $501.19 | $1,862.09 | $32,359.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $363.08 / $363.08 / $363.08
| Facility | AS | $363.08 | $363.08 | $363.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $1,862.09 / $13,182.57
| Facility | | $630.96 | $1,862.09 | $13,182.57 |