- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.14 / $6,251.00 / $11,581.00
| Facility | | $2,200.14 | $6,251.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,405.00 / $16,655.00 / $29,882.70
| Facility | | $3,405.00 | $16,655.00 | $29,882.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,355.98 / $1,479.25 / $2,154.00
| Facility | | $1,355.98 | $1,479.25 | $2,154.00 |
- 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
- $1,723.40 / $1,723.40 / $1,723.40
| Facility | | $1,723.40 | $1,723.40 | $1,723.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.16 / $171.16 / $171.16
| Facility | AS | $171.16 | $171.16 | $171.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |