- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,396.63 / $10,268.00
| Facility | | $1,000.00 | $3,396.63 | $10,268.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,003.00 / $4,142.00 / $19,117.00
| Facility | | $2,003.00 | $4,142.00 | $19,117.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $881.42 / $961.55 / $1,400.14
| Facility | | $881.42 | $961.55 | $1,400.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,133.30 / $1,133.30 / $1,858.17
| Facility | | $1,133.30 | $1,133.30 | $1,858.17 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.26 / $112.26 / $112.26
| Facility | AS | $112.26 | $112.26 | $112.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,793.00 / $6,578.00 / $11,097.00
| Facility | | $3,793.00 | $6,578.00 | $11,097.00 |