- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,137.96 / $14,454.40
| Facility | | $1,000.00 | $2,137.96 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,481.54 / $17,378.01 / $29,512.09
| Facility | | $11,481.54 | $17,378.01 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,691.53 / $3,090.30 / $5,248.07
| Facility | | $2,691.53 | $3,090.30 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $2,089.30 / $6,918.31
| Facility | | $1,023.29 | $2,089.30 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $2,137.96 / $15,135.61
| Facility | | $1,047.13 | $2,137.96 | $15,135.61 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,290.87 / $3,467.37
| Professional | | $1,513.56 | $2,290.87 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,054.61 / $35,481.34 / $54,954.09
| Facility | | $19,054.61 | $35,481.34 | $54,954.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $5,495.41
| Facility | AS | $3,548.13 | $3,548.13 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $17,782.79
| Facility | | $8,912.51 | $13,803.84 | $17,782.79 |