- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $8,644.27
| Facility | | $1,000.00 | $7,838.38 | $8,644.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,800.17 / $11,192.51 / $17,821.25
| Facility | | $3,800.17 | $11,192.51 | $17,821.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.42 / $659.42 / $1,996.40
| Facility | | $659.42 | $659.42 | $1,996.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $65.13 / $65.13 / $65.13
| Facility | AS | $65.13 | $65.13 | $65.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $541.00 / $681.66 / $877.31
| Facility | | $541.00 | $681.66 | $877.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $65.13 / $65.13 / $65.13
| Facility | AS | $65.13 | $65.13 | $65.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $9,127.00 / $10,150.00
| Facility | | $1,230.00 | $9,127.00 | $10,150.00 |