- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $645.66 / $1,419.37 / $6,681.00
| Facility | | $645.66 | $1,419.37 | $6,681.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $110.00 / $147.00 / $8,921.00
| Facility | | $110.00 | $147.00 | $8,921.00 |
- 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
- $5,000.00 / $11,763.36 / $12,045.46
| Facility | | $5,000.00 | $11,763.36 | $12,045.46 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $180.10 / $356.45 / $356.45
| Facility | AS | $180.10 | $356.45 | $356.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,964.00 / $8,273.00 / $23,619.00
| Facility | | $3,964.00 | $8,273.00 | $23,619.00 |