- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,362.27 / $3,604.00 / $53,982.00
| Facility | | $1,362.27 | $3,604.00 | $53,982.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,216.00 / $10,205.00 / $16,534.00
| Facility | | $5,216.00 | $10,205.00 | $16,534.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,000.00 / $15,921.72 / $16,256.07
| Facility | | $11,000.00 | $15,921.72 | $16,256.07 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.58 / $763.43 / $763.43
| Facility | AS | $380.58 | $763.43 | $763.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,986.00 / $19,168.00
| Facility | | $5,052.00 | $10,986.00 | $19,168.00 |