- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,818.38 / $8,511.38
| Facility | | $1,000.00 | $2,818.38 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $10,715.19 / $11,220.18
| Facility | | $9,332.54 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $1,905.46 / $2,511.89
| Facility | | $1,348.96 | $1,905.46 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $2,630.27 / $2,630.27
| Facility | | $34.67 | $2,630.27 | $2,630.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $263.03 / $263.03 / $263.03
| Facility | AS | $263.03 | $263.03 | $263.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |