- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.21 / $5,201.00 / $11,581.00
| Facility | | $700.21 | $5,201.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,576.00 / $14,996.00
| Facility | | $1,760.00 | $3,576.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $430.41 / $469.54 / $683.70
| Facility | | $430.41 | $469.54 | $683.70 |
- 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
- $555.75 / $2,426.17 / $6,198.90
| Facility | | $555.75 | $2,426.17 | $6,198.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $55.33 / $55.33 / $55.33
| Facility | AS | $55.33 | $55.33 | $55.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,647.00 / $4,404.00 / $7,351.00
| Facility | | $2,647.00 | $4,404.00 | $7,351.00 |