- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,715.35 / $12,882.50
| Facility | | $1,000.00 | $3,715.35 | $12,882.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $3,890.45 / $12,589.25
| Facility | | $2,290.87 | $3,890.45 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $331.13 / $2,089.30
| Facility | | $331.13 | $331.13 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $29,512.09
| Facility | | $54.95 | $56.23 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,951.21 / $2,951.21 / $2,951.21
| Facility | AS | $2,951.21 | $2,951.21 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,862.09 / $2,818.38 / $5,248.07
| Facility | | $1,862.09 | $2,818.38 | $5,248.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $2,754.23 / $4,897.79
| Facility | | $2,089.30 | $2,754.23 | $4,897.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $2,454.71 / $10,232.93
| Facility | | $436.52 | $2,454.71 | $10,232.93 |