- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $3,684.00 / $18,600.00
| Facility | | $1,346.00 | $3,684.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,588.83 / $13,547.08 / $21,483.29
| Facility | | $8,588.83 | $13,547.08 | $21,483.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,237.30 / $1,839.89 / $9,537.04
| Facility | | $1,237.30 | $1,839.89 | $9,537.04 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $583.41 / $583.41 / $583.41
| Facility | AS | $583.41 | $583.41 | $583.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,074.00 / $14,139.00
| Facility | | $1,851.00 | $7,074.00 | $14,139.00 |