- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,277.67 / $6,960.04 / $14,579.00
| Facility | | $2,277.67 | $6,960.04 | $14,579.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,932.00 / $41,639.47 / $76,926.81
| Facility | | $6,932.00 | $41,639.47 | $76,926.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,878.73 / $2,049.53 / $2,984.39
| Facility | | $1,878.73 | $2,049.53 | $2,984.39 |
- 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
- $2,410.14 / $2,410.14 / $2,410.14
| Facility | | $2,410.14 | $2,410.14 | $2,410.14 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $238.31 / $238.31 / $238.31
| Facility | AS | $238.31 | $238.31 | $238.31 |
- 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 |