- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,576.00 / $8,400.00
| Facility | | $1,000.00 | $3,576.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,644.08 / $13,662.50 / $21,754.02
| Facility | | $8,644.08 | $13,662.50 | $21,754.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $785.04 / $2,823.22 / $9,412.67
| Facility | | $785.04 | $2,823.22 | $9,412.67 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,454.02 / $2,454.02 / $2,454.02
| Facility | AS | $2,454.02 | $2,454.02 | $2,454.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,280.00 / $5,524.00 / $9,232.95
| Facility | | $1,280.00 | $5,524.00 | $9,232.95 |