- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,218.00 / $18,600.00
| Facility | | $1,000.00 | $3,218.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $35,756.65 / $56,515.54 / $88,413.19
| Facility | | $35,756.65 | $56,515.54 | $88,413.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $771.12 / $4,643.16 / $32,706.80
| Facility | | $771.12 | $4,643.16 | $32,706.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $13,888.08 / $13,888.08 / $13,888.08
| Facility | AS | $13,888.08 | $13,888.08 | $13,888.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $19,870.00 / $32,316.00
| Facility | | $2,840.00 | $19,870.00 | $32,316.00 |