- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,013.14 / $5,493.00 / $13,913.00
| Facility | | $2,013.14 | $5,493.00 | $13,913.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,266.00 / $7,461.00 / $20,057.00
| Facility | | $2,266.00 | $7,461.00 | $20,057.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,956.00 / $17,112.00 / $20,580.00
| Facility | | $7,956.00 | $17,112.00 | $20,580.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.44 / $2,476.16 / $11,000.00
| Facility | | $1,456.44 | $2,476.16 | $11,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.58 / $380.58 / $722.70
| Facility | AS | $380.58 | $380.58 | $722.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $7,904.00 / $19,082.00
| Facility | | $2,578.00 | $7,904.00 | $19,082.00 |