- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,108.49 / $3,143.36 / $8,847.08
| Facility | | $1,108.49 | $3,143.36 | $8,847.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,230.00 / $7,496.00 / $30,285.00
| Facility | | $3,230.00 | $7,496.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.14 / $1,044.17 / $1,305.21
| Facility | | $870.14 | $1,044.17 | $1,305.21 |
- 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
- $1,158.84 / $2,155.67 / $5,018.43
| Facility | | $1,158.84 | $2,155.67 | $5,018.43 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $103.31 / $103.31 / $103.31
| Facility | AS | $103.31 | $103.31 | $103.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,227.00 / $8,448.00 / $13,676.00
| Facility | | $4,227.00 | $8,448.00 | $13,676.00 |