- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $7,943.28 / $56,234.13
| Facility | | $2,238.72 | $7,943.28 | $56,234.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $2,511.89 / $2,511.89
| Facility | | $2,511.89 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $63,095.73
| Facility | | $54.95 | $56.23 | $63,095.73 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $6,309.57 / $6,309.57 / $6,309.57
| Facility | AS | $6,309.57 | $6,309.57 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $3,548.13 / $6,918.31
| Facility | | $1,819.70 | $3,548.13 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,388.44 / $6,456.54
| Facility | | $2,511.89 | $3,388.44 | $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 |