- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $4,826.00 / $14,100.00
| Facility | | $1,456.00 | $4,826.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,301.33 / $17,825.49 / $28,268.11
| Facility | | $11,301.33 | $17,825.49 | $28,268.11 |
- 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
- $1,354.54 / $1,933.25 / $7,567.45
| Facility | | $1,354.54 | $1,933.25 | $7,567.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $631.41 / $631.41 / $631.41
| Facility | AS | $631.41 | $631.41 | $631.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,910.00 / $9,232.95
| Facility | | $1,481.00 | $5,910.00 | $9,232.95 |