- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.69 / $1,849.00 / $10,531.11
| Facility | | $802.69 | $1,849.00 | $10,531.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.86 / $3,066.86 / $4,382.17
| Facility | | $3,066.86 | $3,066.86 | $4,382.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.10 / $852.10 / $6,025.59
| Facility | | $852.10 | $852.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $802.69 / $1,202.11 / $1,814.08
| Facility | | $802.69 | $1,202.11 | $1,814.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $141.26 / $198.94 / $253.97
| Facility | AS | $141.26 | $198.94 | $253.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,619.88 / $19,913.50 / $26,542.00
| Facility | | $4,619.88 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $187.33 / $1,134.79 / $1,887.52
| Facility | AS | $187.33 | $1,134.79 | $1,887.52 |