- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,132.75 / $4,725.54 / $11,418.01
| Facility | | $1,132.75 | $4,725.54 | $11,418.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,134.00 / $7,826.00 / $36,529.00
| Facility | | $2,134.00 | $7,826.00 | $36,529.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $690.69 / $886.45 / $1,097.18
| Facility | | $690.69 | $886.45 | $1,097.18 |
- 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
- $883.12 / $883.12 / $2,525.75
| Facility | | $883.12 | $883.12 | $2,525.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $87.84 / $87.84 / $87.84
| Facility | AS | $87.84 | $87.84 | $87.84 |
- 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 |