- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,557.56 / $5,217.00 / $11,627.00
| Facility | | $1,557.56 | $5,217.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,807.00 / $8,483.00 / $60,294.00
| Facility | | $2,807.00 | $8,483.00 | $60,294.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,095.84 / $1,406.44 / $1,867.92
| Facility | | $1,095.84 | $1,406.44 | $1,867.92 |
- 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
- $1,401.97 / $1,401.97 / $1,401.97
| Facility | | $1,401.97 | $1,401.97 | $1,401.97 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $139.02 / $139.02 / $139.02
| Facility | AS | $139.02 | $139.02 | $139.02 |
- 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 |