- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $100.00 / $2,614.42 / $16,777.58
| Facility | | $100.00 | $2,614.42 | $16,777.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54,000.00 / $75,000.00 / $83,200.00
| Facility | | $54,000.00 | $75,000.00 | $83,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,780.07 / $1,780.07 / $1,780.07
| Facility | | $1,780.07 | $1,780.07 | $1,780.07 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $176.68 / $176.68 / $176.68
| Facility | AS | $176.68 | $176.68 | $176.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,629.00 / $12,629.00 / $12,629.00
| Facility | | $12,629.00 | $12,629.00 | $12,629.00 |