- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,382.00 / $9,608.62 / $22,582.00
| Facility | | $4,382.00 | $9,608.62 | $22,582.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $23,605.99 / $31,048.33 / $60,057.49
| Facility | | $23,605.99 | $31,048.33 | $60,057.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,087.82 / $1,832.88 / $10,010.87
| Facility | | $1,087.82 | $1,832.88 | $10,010.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $441.81 / $441.81 / $441.81
| Facility | AS | $441.81 | $441.81 | $441.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,706.26 / $2,120.40 / $2,877.22
| Facility | | $1,706.26 | $2,120.40 | $2,877.22 |
- 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 |