- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.50 / $4,050.00 / $9,534.00
| Facility | | $1,224.50 | $4,050.00 | $9,534.00 |
- 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
- $1,338.52 / $1,338.52 / $1,338.52
| Facility | | $1,338.52 | $1,338.52 | $1,338.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $132.94 / $132.94 / $132.94
| Facility | AS | $132.94 | $132.94 | $132.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,233.23 / $6,233.23 / $10,335.06
| Facility | | $6,233.23 | $6,233.23 | $10,335.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.50 / $4,993.00 / $10,247.00
| Facility | | $1,224.50 | $4,993.00 | $10,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,338.52 / $1,338.52 / $1,338.52
| Facility | | $1,338.52 | $1,338.52 | $1,338.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $132.94 / $132.94 / $132.94
| Facility | AS | $132.94 | $132.94 | $132.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,154.36 / $1,154.36 / $1,374.48
| Facility | | $1,154.36 | $1,154.36 | $1,374.48 |
- 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 |