- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.54 / $3,681.02 / $6,915.00
| Facility | | $607.54 | $3,681.02 | $6,915.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $6,025.59
| Facility | | $530.04 | $530.04 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $607.54 / $861.24 / $1,265.35
| Facility | | $607.54 | $861.24 | $1,265.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $107.44 / $123.90 / $192.23
| Facility | AS | $107.44 | $123.90 | $192.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,462.48 / $17,381.18 / $19,913.50
| Facility | | $3,462.48 | $17,381.18 | $19,913.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $141.36 / $1,134.79 / $1,887.52
| Facility | AS | $141.36 | $1,134.79 | $1,887.52 |