- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,684.00 / $18,600.00
| Facility | | $1,000.00 | $3,684.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,235.45 / $14,569.03 / $23,181.40
| Facility | | $9,235.45 | $14,569.03 | $23,181.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $514.34 / $885.40 / $6,889.15
| Facility | | $514.34 | $885.40 | $6,889.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,045.32 / $1,045.32 / $1,045.32
| Facility | AS | $1,045.32 | $1,045.32 | $1,045.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,157.00 / $3,858.00 / $7,077.94
| Facility | | $1,157.00 | $3,858.00 | $7,077.94 |