- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,052.17 / $5,132.00 / $22,024.00
| Facility | | $2,052.17 | $5,132.00 | $22,024.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,324.30 / $20,262.22 / $38,781.51
| Facility | | $2,324.30 | $20,262.22 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $230.92 / $770.53 / $770.53
| Facility | AS | $230.92 | $770.53 | $770.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $2,000.00 / $2,285.42
| Facility | | $714.97 | $2,000.00 | $2,285.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,583.17 / $3,277.10 / $6,397.05
| Facility | | $1,583.17 | $3,277.10 | $6,397.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,398.55 / $3,180.83 / $3,407.62
| Facility | | $2,398.55 | $3,180.83 | $3,407.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,173.66 / $2,247.79 / $6,526.97
| Facility | | $2,173.66 | $2,247.79 | $6,526.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $15,486.02 / $20,273.81 / $38,781.51
| Facility | | $15,486.02 | $20,273.81 | $38,781.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $5,547.00 / $19,271.00
| Facility | | $3,028.00 | $5,547.00 | $19,271.00 |