- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,779.00 / $12,600.00
| Facility | | $1,000.00 | $3,779.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,692.09 / $12,132.66 / $19,240.28
| Facility | | $7,692.09 | $12,132.66 | $19,240.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $649.08 / $915.72 / $7,567.45
| Facility | | $649.08 | $915.72 | $7,567.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,279.44 / $1,279.44 / $1,279.44
| Facility | AS | $1,279.44 | $1,279.44 | $1,279.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |