- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,698.27 / $13,168.84
| Facility | | $1,615.00 | $2,698.27 | $13,168.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $13,652.00
| Facility | | $606.10 | $606.10 | $13,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,737.23 / $2,147.31 / $3,439.26
| Facility | | $1,737.23 | $2,147.31 | $3,439.26 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $269.50 / $300.62 / $549.66
| Facility | AS | $269.50 | $300.62 | $549.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $806.00 / $3,994.00 / $6,543.00
| Facility | | $806.00 | $3,994.00 | $6,543.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $22,208.12 / $22,208.12
| Facility | | $5,000.00 | $22,208.12 | $22,208.12 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $247.76 / $431.50 / $867.18
| Facility | AS | $247.76 | $431.50 | $867.18 |