- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.44 / $1,445.44 / $25,703.96
| Facility | | $1,445.44 | $1,445.44 | $25,703.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $35,481.34 / $83,176.38
| Facility | | $9,332.54 | $35,481.34 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $5,370.32 / $12,589.25
| Facility | | $3,801.89 | $5,370.32 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $269.15 / $269.15 / $269.15
| Facility | AS | $269.15 | $269.15 | $269.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $5,128.61 / $10,000.00
| Facility | | $4,073.80 | $5,128.61 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $2,884.03 / $7,585.78
| Facility | | $1,584.89 | $2,884.03 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $6,025.60 / $13,489.63
| Facility | | $1,584.89 | $6,025.60 | $13,489.63 |