- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $11,100.08 / $68,080.00
| Facility | | $4,241.22 | $11,100.08 | $68,080.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,735.08 / $44,370.85 / $85,827.55
| Facility | | $33,735.08 | $44,370.85 | $85,827.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,141.94 / $3,180.26 / $13,909.00
| Facility | | $2,141.94 | $3,180.26 | $13,909.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $864.24 / $864.24 / $864.24
| Facility | AS | $864.24 | $864.24 | $864.24 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,369.27 / $4,187.06 / $5,639.47
| Facility | | $3,369.27 | $4,187.06 | $5,639.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |