- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,357.41 / $5,128.00 / $23,000.00
| Facility | | $1,357.41 | $5,128.00 | $23,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,653.66 / $60,617.23 / $118,585.34
| Facility | | $3,653.66 | $60,617.23 | $118,585.34 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $5,851.88 / $9,733.53 / $9,733.53
| Facility | AS | $5,851.88 | $9,733.53 | $9,733.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $714.97 / $2,285.42 / $42,883.08
| Facility | | $714.97 | $2,285.42 | $42,883.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $877.44 / $1,797.29 / $34,021.94
| Facility | | $877.44 | $1,797.29 | $34,021.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,179.92 / $1,608.67 / $1,715.20
| Facility | | $1,179.92 | $1,608.67 | $1,715.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,128.42 / $1,169.92 / $37,320.03
| Facility | | $1,128.42 | $1,169.92 | $37,320.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $40,810.33 / $61,957.43 / $118,585.34
| Facility | | $40,810.33 | $61,957.43 | $118,585.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,700.00 / $7,614.00 / $24,236.00
| Facility | | $3,700.00 | $7,614.00 | $24,236.00 |