- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $8,763.29
| Facility | | $1,000.00 | $7,838.38 | $8,763.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,345.93 / $15,048.81 / $23,961.46
| Facility | | $4,345.93 | $15,048.81 | $23,961.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $473.24 / $473.24 / $3,456.15
| Facility | | $473.24 | $473.24 | $3,456.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $47.01 / $47.01 / $47.01
| Facility | AS | $47.01 | $47.01 | $47.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $396.74 / $565.83 / $743.64
| Facility | | $396.74 | $565.83 | $743.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $47.01 / $47.01 / $47.01
| Facility | AS | $47.01 | $47.01 | $47.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,705.00 / $11,259.00 / $12,494.00
| Facility | | $1,705.00 | $11,259.00 | $12,494.00 |