- 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
- $1,047.13 / $1,047.13 / $1,047.13
| Facility | | $1,047.13 | $1,047.13 | $1,047.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $20,417.38
| Facility | | $54.95 | $56.23 | $20,417.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,041.74 / $2,041.74 / $2,041.74
| Facility | AS | $2,041.74 | $2,041.74 | $2,041.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,862.09 / $5,128.61
| Facility | | $1,047.13 | $1,862.09 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,621.81 / $2,754.23
| Facility | | $1,202.26 | $1,621.81 | $2,754.23 |
- 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 |