- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $6,918.31 / $22,387.21
| Facility | | $2,511.89 | $6,918.31 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $6,165.95 / $13,803.84
| Facility | | $3,630.78 | $6,165.95 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $2,570.40 / $42,657.95
| Facility | | $66.07 | $2,570.40 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $32,359.37 / $32,359.37 / $38,904.51
| Facility | | $32,359.37 | $32,359.37 | $38,904.51 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $741.31 / $812.83 / $1,122.02
| Professional | | $741.31 | $812.83 | $1,122.02 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $676.08 / $891.25 / $1,659.59
| Professional | | $676.08 | $891.25 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $147,910.84
| Facility | | $54.95 | $56.23 | $147,910.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $14,791.08 / $14,791.08 / $14,791.08
| Facility | AS | $14,791.08 | $14,791.08 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $977.24 / $1,479.11
| Facility | | $776.25 | $977.24 | $1,479.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,022.64 / $23,988.33 / $52,480.75
| Facility | | $12,022.64 | $23,988.33 | $52,480.75 |