- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $6,068.00 / $14,100.00
| Facility | | $1,456.00 | $6,068.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,019.62 / $12,575.25 / $19,618.43
| Facility | | $8,019.62 | $12,575.25 | $19,618.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,721.59 / $7,721.59 / $7,721.59
| Facility | | $7,721.59 | $7,721.59 | $7,721.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,101.68 / $1,563.16 / $14,063.00
| Facility | | $1,101.68 | $1,563.16 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $271.67 / $2,575.09 / $2,575.09
| Facility | AS | $271.67 | $2,575.09 | $2,575.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,307.00 / $14,139.00
| Facility | | $1,851.00 | $7,307.00 | $14,139.00 |