- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,723.00 / $10,817.74
| Facility | | $1,000.00 | $4,723.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $5,770.00 / $30,285.00
| Facility | | $2,670.00 | $5,770.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $667.58 / $856.79 / $1,137.92
| Facility | | $667.58 | $856.79 | $1,137.92 |
- 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
- $854.08 / $854.08 / $854.08
| Facility | | $854.08 | $854.08 | $854.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $84.56 / $84.56 / $84.56
| Facility | AS | $84.56 | $84.56 | $84.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,904.00 / $5,998.00 / $9,245.00
| Facility | | $2,904.00 | $5,998.00 | $9,245.00 |