- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.00 / $8,856.12 / $13,735.62
| Facility | | $1,014.00 | $8,856.12 | $13,735.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,397.92 / $4,397.92 / $6,284.08
| Facility | | $4,397.92 | $4,397.92 | $6,284.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.10 / $852.10 / $15,996.20
| Facility | | $852.10 | $852.10 | $15,996.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,014.00 / $1,461.28 / $2,103.71
| Facility | | $1,014.00 | $1,461.28 | $2,103.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $179.55 / $250.57 / $320.83
| Facility | AS | $179.55 | $250.57 | $320.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,868.00 / $46,141.98 / $54,441.95
| Facility | | $4,868.00 | $46,141.98 | $54,441.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $236.21 / $3,012.55 / $5,010.81
| Facility | AS | $236.21 | $3,012.55 | $5,010.81 |