- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.41 / $2,747.00 / $5,454.00
| Facility | | $564.41 | $2,747.00 | $5,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,170.63 / $3,245.00 / $26,542.00
| Facility | | $1,170.63 | $3,245.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $146.88 / $905.99 / $905.99
| Facility | AS | $146.88 | $905.99 | $905.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,770.00 / $1,947.00 / $3,751.11
| Facility | | $1,770.00 | $1,947.00 | $3,751.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.00 / $1,250.09 / $6,679.00
| Facility | | $578.00 | $1,250.09 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,863.50 / $8,335.86 / $10,614.58
| Facility | | $3,863.50 | $8,335.86 | $10,614.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $5,572.00 / $26,542.00
| Facility | | $1,485.00 | $5,572.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $146.88 / $905.99 / $905.99
| Facility | AS | $146.88 | $905.99 | $905.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,485.00 / $3,245.00 / $7,608.00
| Facility | | $1,485.00 | $3,245.00 | $7,608.00 |