- 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
- $9,332.54 / $10,715.19 / $11,220.18
| Facility | | $9,332.54 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,630.27 / $3,388.44
| Facility | | $1,862.09 | $2,630.27 | $3,388.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $3,548.13 / $3,548.13
| Facility | | $34.67 | $3,548.13 | $3,548.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Facility | AS | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $6,760.83 / $15,488.17
| Facility | | $1,174.90 | $6,760.83 | $15,488.17 |