- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,890.45 / $12,882.50
| Facility | | $1,000.00 | $3,890.45 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,897.79 / $9,549.93
| Facility | | $2,754.23 | $4,897.79 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $549.54 / $588.84
| Facility | | $549.54 | $549.54 | $588.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,238.72 / $2,818.38
| Facility | | $1,000.00 | $2,238.72 | $2,818.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | AS | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,549.93 / $42,657.95 / $42,657.95
| Facility | | $9,549.93 | $42,657.95 | $42,657.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $954.99 / $954.99 / $954.99
| Facility | AS | $954.99 | $954.99 | $954.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $776.25 / $2,290.87
| Facility | | $562.34 | $776.25 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $741.31 / $1,258.93
| Facility | | $549.54 | $741.31 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,011.87 / $10,964.78
| Facility | | $1,698.24 | $5,011.87 | $10,964.78 |