- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,618.06 / $3,939.75 / $7,602.00
| Facility | | $1,618.06 | $3,939.75 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,897.00 / $8,463.00 / $14,914.00
| Facility | | $2,897.00 | $8,463.00 | $14,914.00 |
- 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 / $20,745.75 / $21,205.52
| Facility | | $5,000.00 | $20,745.75 | $21,205.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $322.06 / $640.64 / $640.64
| Facility | AS | $322.06 | $640.64 | $640.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,986.00 / $24,328.00
| Facility | | $5,052.00 | $10,986.00 | $24,328.00 |