- 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
- $2,777.00 / $7,313.00 / $30,285.00
| Facility | | $2,777.00 | $7,313.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $653.16 / $838.27 / $1,113.33
| Facility | | $653.16 | $838.27 | $1,113.33 |
- 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
- $846.52 / $846.52 / $846.52
| Facility | | $846.52 | $846.52 | $846.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $84.30 / $84.30 / $84.30
| Facility | AS | $84.30 | $84.30 | $84.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |