- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $239.34 / $3,696.00 / $11,627.00
| Facility | | $239.34 | $3,696.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,890.11 / $4,089.29 / $7,408.79
| Facility | | $1,890.11 | $4,089.29 | $7,408.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $237.15 / $258.70 / $376.72
| Facility | | $237.15 | $258.70 | $376.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $302.33 / $302.33 / $302.33
| Facility | | $302.33 | $302.33 | $302.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $29.68 / $29.68 / $29.68
| Facility | AS | $29.68 | $29.68 | $29.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |