- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,223.00 / $10,817.74
| Facility | | $1,000.00 | $5,223.00 | $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
- $673.35 / $864.20 / $1,147.77
| Facility | | $673.35 | $864.20 | $1,147.77 |
- 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
- $859.48 / $859.48 / $859.48
| Facility | | $859.48 | $859.48 | $859.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.26 / $85.26 / $85.26
| Facility | AS | $85.26 | $85.26 | $85.26 |
- 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 |