- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $2,884.03 / $8,317.64
| Facility | | $776.25 | $2,884.03 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,818.38 / $5,888.44
| Facility | | $1,584.89 | $2,818.38 | $5,888.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $79.43 / $537.03 / $549.54
| Facility | | $79.43 | $537.03 | $549.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,248.07 / $28,840.32 / $28,840.32
| Facility | | $5,248.07 | $28,840.32 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $524.81 / $524.81 / $524.81
| Facility | AS | $524.81 | $524.81 | $524.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $812.83 / $3,715.35
| Facility | | $549.54 | $812.83 | $3,715.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $724.44 / $1,288.25
| Facility | | $549.54 | $724.44 | $1,288.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | AS | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $4,073.80 / $8,912.51
| Facility | | $1,380.38 | $4,073.80 | $8,912.51 |