- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,526.58 / $4,500.00 / $20,680.40
| Facility | | $1,526.58 | $4,500.00 | $20,680.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,897.00 / $19,823.93 / $38,781.51
| Facility | | $5,897.00 | $19,823.93 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,134.79 / $1,887.52 / $1,887.52
| Facility | AS | $1,134.79 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $2,285.42 / $8,315.84
| Facility | | $2,000.00 | $2,285.42 | $8,315.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,281.94 / $2,604.06 / $7,292.72
| Facility | | $1,281.94 | $2,604.06 | $7,292.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,739.50 / $2,370.41 / $2,505.80
| Facility | | $1,739.50 | $2,370.41 | $2,505.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,652.54 / $1,709.18 / $6,526.97
| Facility | | $1,652.54 | $1,709.18 | $6,526.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,146.66 / $20,262.22 / $38,781.51
| Facility | | $13,146.66 | $20,262.22 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |