- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,991.15 / $2,747.00 / $5,454.00
| Facility | | $1,991.15 | $2,747.00 | $5,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,188.33 / $5,071.00 / $17,007.30
| Facility | | $2,188.33 | $5,071.00 | $17,007.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $476.09 / $476.09 / $960.23
| Facility | AS | $476.09 | $476.09 | $960.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $2,000.00 / $3,000.00
| Facility | | $2,000.00 | $2,000.00 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $300.00 / $2,938.60 / $8,090.00
| Facility | | $300.00 | $2,938.60 | $8,090.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $6,238.00 / $20,145.59
| Facility | | $2,485.00 | $6,238.00 | $20,145.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $476.09 / $476.09 / $960.23
| Facility | AS | $476.09 | $476.09 | $960.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $6,474.00 / $13,737.00
| Facility | | $2,485.00 | $6,474.00 | $13,737.00 |