- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.98 / $5,217.00 / $11,627.00
| Facility | | $934.98 | $5,217.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $6,565.00 / $30,285.00
| Facility | | $2,777.00 | $6,565.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.11 / $738.11 / $980.30
| Facility | | $575.11 | $738.11 | $980.30 |
- 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
- $741.37 / $741.37 / $1,732.50
| Facility | | $741.37 | $741.37 | $1,732.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $73.78 / $73.78 / $73.78
| Facility | AS | $73.78 | $73.78 | $73.78 |
- 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 |