- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $5,946.00 / $14,100.00
| Facility | | $1,456.00 | $5,946.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $18,768.65 / $29,430.37 / $45,913.76
| Facility | | $18,768.65 | $29,430.37 | $45,913.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,641.49 / $14,641.49 / $14,641.49
| Facility | | $14,641.49 | $14,641.49 | $14,641.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,212.02 / $1,665.18 / $18,992.00
| Facility | | $1,212.02 | $1,665.18 | $18,992.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $291.30 / $4,882.81 / $4,882.81
| Facility | AS | $291.30 | $4,882.81 | $4,882.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,470.00 / $11,829.54 / $20,423.23
| Facility | | $3,470.00 | $11,829.54 | $20,423.23 |