- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,163.00 / $6,813.00 / $14,579.00
| Facility | | $2,163.00 | $6,813.00 | $14,579.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,920.00 / $41,878.69 / $76,926.81
| Facility | | $5,920.00 | $41,878.69 | $76,926.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,602.84 / $1,748.56 / $2,546.14
| Facility | | $1,602.84 | $1,748.56 | $2,546.14 |
- 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
- $2,043.18 / $2,043.18 / $2,043.18
| Facility | | $2,043.18 | $2,043.18 | $2,043.18 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $202.55 / $202.55 / $202.55
| Facility | AS | $202.55 | $202.55 | $202.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,873.00 / $10,529.00 / $15,469.00
| Facility | | $4,873.00 | $10,529.00 | $15,469.00 |