- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $3,981.07 / $8,317.64
| Facility | | $1,047.13 | $3,981.07 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $5,248.07 / $57,543.99
| Facility | | $5,011.87 | $5,248.07 | $57,543.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | AS | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $9,332.54 / $24,547.09
| Facility | | $3,090.30 | $9,332.54 | $24,547.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.99 / $2,691.53 / $8,317.64
| Facility | | $954.99 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $776.25 / $1,230.27
| Facility | | $776.25 | $776.25 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $416.87 / $416.87 / $741.31
| Facility | | $416.87 | $416.87 | $741.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $3,311.31 / $6,309.57
| Facility | | $1,348.96 | $3,311.31 | $6,309.57 |