- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.87 / $4,701.34 / $8,413.00
| Facility | | $801.87 | $4,701.34 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,794.89 / $1,794.89 / $1,821.08
| Facility | | $1,794.89 | $1,794.89 | $1,821.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,062.80
| Facility | | $606.10 | $606.10 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.25 / $935.52 / $1,369.81
| Facility | | $717.25 | $935.52 | $1,369.81 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $129.83 / $130.97 / $236.98
| Facility | AS | $129.83 | $130.97 | $236.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,950.27 / $6,817.20
| Facility | | $55.00 | $5,950.27 | $6,817.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $164.59 / $388.48 / $646.16
| Facility | AS | $164.59 | $388.48 | $646.16 |