- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.16 / $5,866.00 / $16,467.00
| Facility | | $644.16 | $5,866.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,097.16
| Facility | | $3,366.50 | $7,206.40 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $650.60 / $5,740.31
| Facility | | $505.00 | $650.60 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $64.05 / $64.05 / $64.05
| Facility | AS | $64.05 | $64.05 | $64.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.83 / $738.41 / $1,208.68
| Facility | | $572.83 | $738.41 | $1,208.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $90.18 / $104.16 / $164.70
| Facility | AS | $90.18 | $104.16 | $164.70 |
- 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 |