- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $578.01 / $9,062.00 / $18,276.00
| Facility | | $578.01 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,212.57
| Facility | | $3,366.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.83 / $715.00 / $5,740.31
| Facility | | $575.83 | $715.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $57.12 / $57.12 / $57.12
| Facility | AS | $57.12 | $57.12 | $57.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $506.00 / $684.60 / $1,109.55
| Facility | | $506.00 | $684.60 | $1,109.55 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $71.69 / $101.78 / $148.12
| Facility | AS | $71.69 | $101.78 | $148.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |