- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $2,344.23 / $8,317.64
| Facility | | $426.58 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $630.96 / $630.96
| Facility | | $630.96 | $630.96 | $630.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $63.10 / $63.10 / $63.10
| Facility | AS | $63.10 | $63.10 | $63.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $9,549.93 / $13,182.57
| Facility | | $1,000.00 | $9,549.93 | $13,182.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.63 / $1,995.26 / $7,762.47
| Facility | | $478.63 | $1,995.26 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $660.69 / $758.58
| Facility | | $660.69 | $660.69 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $309.03 / $363.08 / $575.44
| Facility | | $309.03 | $363.08 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,548.13 / $10,000.00
| Facility | | $1,348.96 | $3,548.13 | $10,000.00 |