- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,356.16 / $4,500.00 / $20,680.40
| Facility | | $2,356.16 | $4,500.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,166.00 / $10,160.00 / $16,005.52
| Facility | | $1,166.00 | $10,160.00 | $16,005.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $240.02 / $787.03 / $787.03
| Facility | AS | $240.02 | $787.03 | $787.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $500.00 / $714.97 / $947.00
| Facility | | $500.00 | $714.97 | $947.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,651.06 / $3,418.66 / $4,428.91
| Facility | | $1,651.06 | $3,418.66 | $4,428.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,499.98 / $3,315.43 / $3,475.96
| Facility | | $2,499.98 | $3,315.43 | $3,475.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,339.75 / $2,339.75 / $2,370.92
| Facility | | $2,339.75 | $2,339.75 | $2,370.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,831.44 / $11,831.44 / $14,905.81
| Facility | | $11,831.44 | $11,831.44 | $14,905.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.00 / $1,120.00 / $5,793.00
| Facility | | $650.00 | $1,120.00 | $5,793.00 |