- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,885.46 / $9,062.00 / $18,276.00
| Facility | | $1,885.46 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,313.35 / $20,940.59 / $43,255.22
| Facility | | $2,313.35 | $20,940.59 | $43,255.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $1,888.69
| Facility | | $890.00 | $890.00 | $1,888.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $187.04 / $187.04 / $187.04
| Facility | AS | $187.04 | $187.04 | $187.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,832.56 / $2,185.00 / $3,507.61
| Facility | | $1,832.56 | $2,185.00 | $3,507.61 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $280.01 / $305.89 / $491.07
| Facility | AS | $280.01 | $305.89 | $491.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $19,915.00 / $30,476.00
| Facility | | $3,340.00 | $19,915.00 | $30,476.00 |