- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $956.50 / $4,182.08 / $12,765.09
| Facility | | $956.50 | $4,182.08 | $12,765.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,009.30 / $3,958.05 / $7,656.16
| Facility | | $3,009.30 | $3,958.05 | $7,656.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.40 / $1,387.40 / $1,387.40
| Facility | | $1,387.40 | $1,387.40 | $1,387.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.83 / $926.18 / $3,253.20
| Facility | | $510.83 | $926.18 | $3,253.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $143.22 / $497.27 / $497.27
| Facility | AS | $143.22 | $497.27 | $497.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,373.80 / $1,757.37
| Facility | | $953.00 | $1,373.80 | $1,757.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,217.00 / $6,451.00 / $7,934.00
| Facility | | $4,217.00 | $6,451.00 | $7,934.00 |