- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,037.28 / $4,264.00 / $9,085.23
| Facility | | $1,037.28 | $4,264.00 | $9,085.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,531.00 / $27,840.00 / $46,296.00
| Facility | | $13,531.00 | $27,840.00 | $46,296.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.08 / $1,130.08 / $1,130.08
| Facility | | $1,130.08 | $1,130.08 | $1,130.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.33 / $112.33 / $112.33
| Facility | AS | $112.33 | $112.33 | $112.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,064.48 / $18,064.48 / $18,064.48
| Facility | | $18,064.48 | $18,064.48 | $18,064.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.00 / $4,761.00 / $9,211.00
| Facility | | $1,020.00 | $4,761.00 | $9,211.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,130.08 / $1,130.08 / $1,130.08
| Facility | | $1,130.08 | $1,130.08 | $1,130.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.33 / $112.33 / $112.33
| Facility | AS | $112.33 | $112.33 | $112.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $975.05 / $975.05 / $1,271.38
| Facility | | $975.05 | $975.05 | $1,271.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.00 / $4,563.00 / $9,631.00
| Facility | | $2,468.00 | $4,563.00 | $9,631.00 |