- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.33 / $5,355.00 / $10,817.74
| Facility | | $830.33 | $5,355.00 | $10,817.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $6,003.00 / $30,285.00
| Facility | | $2,670.00 | $6,003.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $510.50 / $655.19 / $870.17
| Facility | | $510.50 | $655.19 | $870.17 |
- 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
- $654.32 / $654.32 / $654.32
| Facility | | $654.32 | $654.32 | $654.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $65.13 / $65.13 / $65.13
| Facility | AS | $65.13 | $65.13 | $65.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |