- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.55 / $7,439.00 / $25,044.77
| Facility | | $1,055.55 | $7,439.00 | $25,044.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,855.05 / $6,855.05 / $6,955.07
| Facility | | $6,855.05 | $6,855.05 | $6,955.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $15,449.08
| Facility | | $748.70 | $748.70 | $15,449.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.55 / $1,354.00 / $2,111.71
| Facility | | $1,055.55 | $1,354.00 | $2,111.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $183.62 / $189.56 / $333.98
| Facility | AS | $183.62 | $189.56 | $333.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $14,893.00 / $22,265.00
| Facility | | $4,317.00 | $14,893.00 | $22,265.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,080.10 / $44,563.83 / $51,056.45
| Facility | | $6,080.10 | $44,563.83 | $51,056.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $246.36 / $2,909.51 / $4,839.43
| Facility | AS | $246.36 | $2,909.51 | $4,839.43 |