- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,138.69 / $7,365.00 / $20,750.00
| Facility | | $2,138.69 | $7,365.00 | $20,750.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.00 / $6,975.00 / $22,011.00
| Facility | | $2,232.00 | $6,975.00 | $22,011.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,761.00 / $28,914.00 / $32,857.00
| Facility | | $17,761.00 | $28,914.00 | $32,857.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,508.84 / $2,467.73 / $45,000.00
| Facility | | $1,508.84 | $2,467.73 | $45,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $398.38 / $398.38 / $7,529.59
| Facility | AS | $398.38 | $398.38 | $7,529.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,209.00 / $6,201.00 / $15,000.00
| Facility | | $2,209.00 | $6,201.00 | $15,000.00 |