- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,630.27 / $6,606.93
| Facility | | $1,000.00 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,715.19 / $14,454.40 / $19,952.62
| Facility | | $10,715.19 | $14,454.40 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $891.25
| Facility | | $891.25 | $891.25 | $891.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $1,122.02 / $11,220.18
| Facility | | $588.84 | $1,122.02 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.54 / $269.15 / $269.15
| Facility | AS | $144.54 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $7,244.36 / $14,125.38
| Facility | | $1,862.09 | $7,244.36 | $14,125.38 |