- 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
- $18,197.01 / $28,183.83 / $45,708.82
| Facility | | $18,197.01 | $28,183.83 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.00 / $8,709.64 / $30,902.95
| Facility | | $302.00 | $8,709.64 | $30,902.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.82 / $114.82 / $114.82
| Facility | AS | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $19,952.62 / $33,884.42
| Facility | | $6,918.31 | $19,952.62 | $33,884.42 |