- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $1,584.89 / $8,128.31
| Facility | | $1,584.89 | $1,584.89 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $37,153.52 / $83,176.38
| Facility | | $10,000.00 | $37,153.52 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,754.40 / $13,803.84
| Facility | | $4,073.80 | $5,754.40 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $281.84 / $281.84 / $281.84
| Facility | AS | $281.84 | $281.84 | $281.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $5,623.41 / $10,964.78
| Facility | | $4,466.84 | $5,623.41 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $3,019.95 / $7,585.78
| Facility | | $1,659.59 | $3,019.95 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $8,128.31 / $28,183.83
| Facility | | $1,584.89 | $8,128.31 | $28,183.83 |