- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,253.84 / $3,060.00 / $9,923.87
| Facility | | $1,253.84 | $3,060.00 | $9,923.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,283.00 / $4,975.00 / $11,448.00
| Facility | | $3,283.00 | $4,975.00 | $11,448.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.32 / $1,487.32 / $37,499.62
| Facility | | $1,487.32 | $1,487.32 | $37,499.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,199.82 / $1,199.82 / $7,227.90
| Facility | | $1,199.82 | $1,199.82 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $117.55 / $117.55 / $117.55
| Facility | AS | $117.55 | $117.55 | $117.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.00 / $1,536.00 / $2,802.76
| Facility | | $332.00 | $1,536.00 | $2,802.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $972.93 / $972.93 / $972.93
| Facility | | $972.93 | $972.93 | $972.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $597.00 / $1,199.82 / $7,227.90
| Facility | | $597.00 | $1,199.82 | $7,227.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $117.55 / $117.55 / $117.55
| Facility | AS | $117.55 | $117.55 | $117.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $996.00 / $4,194.00 / $9,020.04
| Facility | | $996.00 | $4,194.00 | $9,020.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,245.65 / $1,245.65 / $3,815.17
| Facility | | $1,245.65 | $1,245.65 | $3,815.17 |