- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $950.00 / $5,569.30 / $9,863.00
| Facility | | $950.00 | $5,569.30 | $9,863.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $3,683.00 / $14,996.00
| Facility | | $1,760.00 | $3,683.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $552.38 / $708.94 / $941.55
| Facility | | $552.38 | $708.94 | $941.55 |
- 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
- $707.51 / $707.51 / $707.51
| Facility | | $707.51 | $707.51 | $707.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $70.31 / $70.31 / $70.31
| Facility | AS | $70.31 | $70.31 | $70.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,625.00 / $7,853.00
| Facility | | $2,840.00 | $5,625.00 | $7,853.00 |