- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,818.38 / $7,762.47
| Facility | | $1,000.00 | $2,818.38 | $7,762.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,819.70 / $4,168.69
| Facility | | $676.08 | $1,819.70 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,118.86 / $25,118.86 / $25,118.86
| Facility | | $25,118.86 | $25,118.86 | $25,118.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $245.47 / $1,230.27
| Facility | | $54.95 | $245.47 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $35.48 / $69.18 / $69.18
| Facility | AS | $35.48 | $69.18 | $69.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $338.84 / $707.95 / $1,778.28
| Facility | | $338.84 | $707.95 | $1,778.28 |