- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.04 / $2,724.23 / $11,384.90
| Facility | | $705.04 | $2,724.23 | $11,384.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.04 / $985.04 / $1,439.13
| Facility | | $705.04 | $985.04 | $1,439.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.41 / $146.02 / $223.07
| Facility | AS | $122.41 | $146.02 | $223.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,629.00 / $8,549.00 / $13,997.00
| Facility | | $2,629.00 | $8,549.00 | $13,997.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,049.10 / $8,957.00 / $26,542.00
| Facility | | $4,049.10 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $164.43 / $510.42 / $849.00
| Facility | AS | $164.43 | $510.42 | $849.00 |