- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,856.26 / $3,310.66 / $7,602.00
| Facility | | $1,856.26 | $3,310.66 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $2,387.00 / $6,366.00
| Facility | | $1,375.00 | $2,387.00 | $6,366.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,000.00 / $15,933.96 / $16,278.30
| Facility | | $5,000.00 | $15,933.96 | $16,278.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.34 / $762.69 / $762.69
| Facility | AS | $380.34 | $762.69 | $762.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,986.00 / $19,168.00
| Facility | | $5,052.00 | $10,986.00 | $19,168.00 |