- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $15,488.17 / $31,622.78
| Facility | | $1,698.24 | $15,488.17 | $31,622.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,803.84 / $18,620.87 / $29,512.09
| Facility | | $13,803.84 | $18,620.87 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $2,511.89 / $3,981.07
| Facility | | $2,137.96 | $2,511.89 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $3,162.28 / $5,888.44
| Facility | | $831.76 | $3,162.28 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $15,848.93 / $26,915.35
| Facility | | $912.01 | $15,848.93 | $26,915.35 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $933.25 / $1,737.80 / $2,511.89
| Professional | | $933.25 | $1,737.80 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100,000.00 / $100,000.00 / $147,910.84
| Facility | | $100,000.00 | $100,000.00 | $147,910.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $14,791.08
| Facility | AS | $10,000.00 | $10,000.00 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,964.78 / $20,892.96 / $27,542.29
| Facility | | $10,964.78 | $20,892.96 | $27,542.29 |