- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $3,162.28 / $10,000.00
| Facility | | $1,148.15 | $3,162.28 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $11,748.98 / $29,512.09
| Facility | | $5,011.87 | $11,748.98 | $29,512.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $1,230.27 / $13,489.63
| Facility | | $1,230.27 | $1,230.27 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,513.56 / $50,118.72
| Facility | | $34.67 | $1,513.56 | $50,118.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $151.36 / $151.36 / $151.36
| Facility | AS | $151.36 | $151.36 | $151.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.96 / $1,096.48 / $3,467.37
| Facility | | $870.96 | $1,096.48 | $3,467.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $831.76 / $831.76
| Facility | | $831.76 | $831.76 | $831.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $50,118.72 / $75,857.76
| Facility | | $630.96 | $50,118.72 | $75,857.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $8,128.31 / $36,307.81
| Facility | | $2,454.71 | $8,128.31 | $36,307.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $1,023.29 / $1,479.11
| Facility | | $724.44 | $1,023.29 | $1,479.11 |