- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $4,856.00 / $14,100.00
| Facility | | $1,392.00 | $4,856.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,723.84 / $13,644.59 / $21,288.26
| Facility | | $8,723.84 | $13,644.59 | $21,288.26 |
- 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
- $1,100.00 / $1,535.78 / $10,160.00
| Facility | | $1,100.00 | $1,535.78 | $10,160.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $2,105.03 / $2,105.03 / $2,105.03
| Facility | AS | $2,105.03 | $2,105.03 | $2,105.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,307.00 / $14,587.03
| Facility | | $1,851.00 | $7,307.00 | $14,587.03 |