- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,683.00 / $8,400.00
| Facility | | $1,000.00 | $3,683.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,132.98 / $14,509.07 / $22,924.17
| Facility | | $9,132.98 | $14,509.07 | $22,924.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,545.78 / $2,545.78 / $2,545.78
| Facility | | $2,545.78 | $2,545.78 | $2,545.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.57 / $1,009.44 / $6,840.79
| Facility | | $724.57 | $1,009.44 | $6,840.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $178.12 / $849.00 / $849.00
| Facility | AS | $178.12 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,243.00 / $4,424.00 / $7,077.94
| Facility | | $1,243.00 | $4,424.00 | $7,077.94 |