- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,742.00 / $18,600.00
| Facility | | $1,000.00 | $3,742.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,444.76 / $15,004.39 / $23,706.76
| Facility | | $9,444.76 | $15,004.39 | $23,706.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $900.00
| Facility | | $900.00 | $900.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $871.73 / $1,395.77 / $5,882.00
| Facility | | $871.73 | $1,395.77 | $5,882.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $275.18 / $516.36 / $516.36
| Facility | AS | $275.18 | $516.36 | $516.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.00 / $1,760.00 / $6,155.68
| Facility | | $350.00 | $1,760.00 | $6,155.68 |