- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,818.38 / $8,511.38
| Facility | | $1,000.00 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,715.19 / $11,220.18
| Facility | | $7,244.36 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,737.80 / $2,290.87
| Facility | | $1,202.26 | $1,737.80 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,570.40 / $2,570.40
| Facility | | $34.67 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $257.04 / $257.04 / $257.04
| Facility | AS | $257.04 | $257.04 | $257.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |