- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $4,500.00 / $15,911.55
| Facility | | $1,150.00 | $4,500.00 | $15,911.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.50 / $12,508.22 / $19,762.84
| Facility | | $7,873.50 | $12,508.22 | $19,762.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,138.04 / $7,138.04 / $7,138.04
| Facility | | $7,138.04 | $7,138.04 | $7,138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.58 / $937.63 / $14,063.00
| Facility | | $654.58 | $937.63 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $162.91 / $2,380.48 / $2,380.48
| Facility | AS | $162.91 | $2,380.48 | $2,380.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,074.00 / $14,139.00
| Facility | | $1,851.00 | $7,074.00 | $14,139.00 |