- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $712.82 / $5,463.36 / $13,841.56
| Facility | | $712.82 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,349.44 / $9,666.52 / $18,698.16
| Facility | | $7,349.44 | $9,666.52 | $18,698.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $566.73 / $991.78 / $8,816.00
| Facility | | $566.73 | $991.78 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.81 / $1,887.52 / $1,887.52
| Facility | AS | $158.81 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $953.00 / $1,522.00 / $6,616.19
| Facility | | $953.00 | $1,522.00 | $6,616.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $8,816.00 / $10,575.11
| Facility | | $5,341.00 | $8,816.00 | $10,575.11 |