- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,168.69 / $10,471.29 / $23,988.33
| Facility | | $4,168.69 | $10,471.29 | $23,988.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $13,489.63 / $22,387.21
| Facility | | $7,943.28 | $13,489.63 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $66.07 / $5,128.61 / $18,197.01
| Facility | | $66.07 | $5,128.61 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $10,000.00 / $10,000.00 / $10,000.00
| Facility | | $10,000.00 | $10,000.00 | $10,000.00 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,258.93 / $1,698.24
| Professional | | $1,047.13 | $1,258.93 | $1,698.24 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,380.38 / $2,137.96
| Professional | | $1,047.13 | $1,380.38 | $2,137.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $56.23 / $16,982.44
| Facility | | $54.95 | $56.23 | $16,982.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | AS | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $1,513.56 / $2,570.40
| Facility | | $1,174.90 | $1,513.56 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $14,791.08 / $35,481.34
| Facility | | $7,762.47 | $14,791.08 | $35,481.34 |