- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,034.48 / $7,439.00
| Facility | | $1,615.00 | $2,034.48 | $7,439.00 |
- 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
- $2,034.48 / $2,516.05 / $4,034.79
| Facility | | $2,034.48 | $2,516.05 | $4,034.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $320.45 / $352.25 / $643.71
| Facility | AS | $320.45 | $352.25 | $643.71 |
- 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 / $26,015.66 / $26,015.66
| Facility | | $5,000.00 | $26,015.66 | $26,015.66 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $290.24 / $502.82 / $1,013.65
| Facility | AS | $290.24 | $502.82 | $1,013.65 |