- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $874.32 / $6,582.00 / $11,627.00
| Facility | | $874.32 | $6,582.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,315.00 / $41,878.69 / $76,926.81
| Facility | | $3,315.00 | $41,878.69 | $76,926.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $795.88 / $1,021.45 / $1,356.62
| Facility | | $795.88 | $1,021.45 | $1,356.62 |
- 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
- $1,021.03 / $1,021.03 / $1,021.03
| Facility | | $1,021.03 | $1,021.03 | $1,021.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.07 / $100.07 / $100.07
| Facility | AS | $100.07 | $100.07 | $100.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,351.00 / $11,267.00 / $15,869.00
| Facility | | $5,351.00 | $11,267.00 | $15,869.00 |