- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,558.70 / $6,251.00 / $11,581.00
| Facility | | $1,558.70 | $6,251.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,969.00 / $9,153.00 / $60,320.00
| Facility | | $2,969.00 | $9,153.00 | $60,320.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $947.07 / $1,033.16 / $1,504.42
| Facility | | $947.07 | $1,033.16 | $1,504.42 |
- 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
- $1,217.95 / $1,217.95 / $1,217.95
| Facility | | $1,217.95 | $1,217.95 | $1,217.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $121.06 / $121.06 / $121.06
| Facility | AS | $121.06 | $121.06 | $121.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $9,125.00 / $18,211.00
| Facility | | $4,070.00 | $9,125.00 | $18,211.00 |