- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,756.00 / $13,200.00
| Facility | | $1,346.00 | $4,756.00 | $13,200.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,104.02 / $19,229.00 / $30,381.63
| Facility | | $12,104.02 | $19,229.00 | $30,381.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,648.33 / $7,648.33 / $7,648.33
| Facility | | $7,648.33 | $7,648.33 | $7,648.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $819.29 / $1,149.52 / $14,063.00
| Facility | | $819.29 | $1,149.52 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $200.61 / $2,550.66 / $2,550.66
| Facility | AS | $200.61 | $2,550.66 | $2,550.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $6,871.00 / $14,139.00
| Facility | | $1,851.00 | $6,871.00 | $14,139.00 |