- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,592.98 / $6,251.00 / $11,581.00
| Facility | | $1,592.98 | $6,251.00 | $11,581.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,405.00 / $29,300.94 / $53,822.78
| Facility | | $3,405.00 | $29,300.94 | $53,822.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.52 / $1,257.13 / $1,669.64
| Facility | | $979.52 | $1,257.13 | $1,669.64 |
- 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
- $1,250.74 / $1,250.74 / $1,250.74
| Facility | | $1,250.74 | $1,250.74 | $1,250.74 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $124.19 / $124.19 / $124.19
| Facility | AS | $124.19 | $124.19 | $124.19 |
- 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 |