- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $822.32 / $13,147.68 / $23,856.49
| Facility | | $822.32 | $13,147.68 | $23,856.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,433.47 / $36,627.79 / $70,860.36
| Facility | | $5,433.47 | $36,627.79 | $70,860.36 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $141.29 / $462.93 / $462.93
| Facility | AS | $141.29 | $462.93 | $462.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $765.00 / $870.49
| Facility | | $714.97 | $765.00 | $870.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $951.39 / $1,928.37 / $2,751.97
| Facility | | $951.39 | $1,928.37 | $2,751.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,429.76 / $1,901.46 / $2,030.77
| Facility | | $1,429.76 | $1,901.46 | $2,030.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,349.03 / $1,349.03 / $1,385.17
| Facility | | $1,349.03 | $1,349.03 | $1,385.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,977.90 / $36,627.79 / $70,064.83
| Facility | | $27,977.90 | $36,627.79 | $70,064.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |