- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,072.00 / $11,581.00
| Facility | | $1,000.00 | $5,072.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,674.00 / $6,669.00 / $30,285.00
| Facility | | $2,674.00 | $6,669.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.86 / $754.48 / $1,002.05
| Facility | | $587.86 | $754.48 | $1,002.05 |
- 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
- $755.12 / $755.12 / $755.12
| Facility | | $755.12 | $755.12 | $755.12 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $74.86 / $74.86 / $74.86
| Facility | AS | $74.86 | $74.86 | $74.86 |
- 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 |