- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $14,454.40
| Facility | | $1,000.00 | $3,715.35 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $5,011.87 / $27,542.29
| Facility | | $2,884.03 | $5,011.87 | $27,542.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,630.78 / $3,630.78
| Facility | | $2,570.40 | $3,630.78 | $3,630.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $64,565.42
| Facility | | $54.95 | $56.23 | $64,565.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $6,456.54 / $6,456.54 / $6,456.54
| Facility | AS | $6,456.54 | $6,456.54 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.80 / $3,630.78 / $7,585.78
| Facility | | $1,737.80 | $3,630.78 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $3,548.13 / $6,456.54
| Facility | | $2,570.40 | $3,548.13 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,454.71 / $10,232.93
| Facility | | $436.52 | $2,454.71 | $10,232.93 |