- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,683.00 / $8,400.00
| Facility | | $1,000.00 | $3,683.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $27,398.61 / $43,526.71 / $68,269.22
| Facility | | $27,398.61 | $43,526.71 | $68,269.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,390.09 / $23,390.09 / $23,390.09
| Facility | | $23,390.09 | $23,390.09 | $23,390.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $344.04 / $612.51 / $32,093.31
| Facility | | $344.04 | $612.51 | $32,093.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $97.26 / $7,800.40 / $7,800.40
| Facility | AS | $97.26 | $7,800.40 | $7,800.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,860.00 / $20,100.00 / $33,856.83
| Facility | | $4,860.00 | $20,100.00 | $33,856.83 |