- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,062.67 / $4,590.00 / $10,817.74
| Facility | | $1,062.67 | $4,590.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,528.00 / $14,996.00
| Facility | | $1,712.00 | $3,528.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.53 / $840.05 / $1,115.69
| Facility | | $654.53 | $840.05 | $1,115.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $834.41 / $834.41 / $834.41
| Facility | | $834.41 | $834.41 | $834.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $82.62 / $82.62 / $82.62
| Facility | AS | $82.62 | $82.62 | $82.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,223.00 / $6,522.00
| Facility | | $2,233.00 | $4,223.00 | $6,522.00 |