- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.00 / $2,894.76 / $6,617.00
| Facility | | $2,528.00 | $2,894.76 | $6,617.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.45 / $4,473.70 / $17,660.83
| Facility | | $1,036.45 | $4,473.70 | $17,660.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $243.32 / $243.32 / $479.09
| Facility | AS | $243.32 | $243.32 | $479.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $25,542.85 / $25,542.85 / $26,356.21
| Facility | | $25,542.85 | $25,542.85 | $26,356.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.39 / $1,909.00 / $6,679.00
| Facility | | $954.39 | $1,909.00 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,751.20 / $12,850.00
| Facility | | $55.00 | $4,751.20 | $12,850.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $243.32 / $243.32 / $479.09
| Facility | AS | $243.32 | $243.32 | $479.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.00 / $5,097.00 / $10,764.00
| Facility | | $2,324.00 | $5,097.00 | $10,764.00 |