- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,507.39 / $8,289.00 / $12,096.23
| Facility | | $1,507.39 | $8,289.00 | $12,096.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $6,932.00 / $30,285.00
| Facility | | $2,777.00 | $6,932.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.63 / $973.64 / $1,205.09
| Facility | | $758.63 | $973.64 | $1,205.09 |
- 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
- $969.02 / $969.02 / $2,062.67
| Facility | | $969.02 | $969.02 | $2,062.67 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $96.34 / $96.34 / $96.34
| Facility | AS | $96.34 | $96.34 | $96.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,231.00 / $10,075.00
| Facility | | $3,206.00 | $6,231.00 | $10,075.00 |