- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $272.13 / $7,602.00 / $52,899.52
| Facility | | $272.13 | $7,602.00 | $52,899.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.00 / $143.00 / $388.00
| Facility | | $108.00 | $143.00 | $388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $576.76 / $594.13
| Facility | | $55.00 | $576.76 | $594.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $30.81 / $59.41 / $59.41
| Facility | AS | $30.81 | $59.41 | $59.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,665.00 / $4,918.00
| Facility | | $1,233.00 | $2,665.00 | $4,918.00 |