- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $5,135.00 / $10,635.00
| Facility | | $900.00 | $5,135.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $7,180.00 / $30,285.00
| Facility | | $2,777.00 | $7,180.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.19 / $612.42 / $813.39
| Facility | | $477.19 | $612.42 | $813.39 |
- 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
- $611.16 / $611.16 / $611.16
| Facility | | $611.16 | $611.16 | $611.16 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $60.51 / $60.51 / $60.51
| Facility | AS | $60.51 | $60.51 | $60.51 |
- 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 |