- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $867.57 / $9,062.00 / $18,276.00
| Facility | | $867.57 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,268.85 / $10,249.16 / $18,360.62
| Facility | | $4,268.85 | $10,249.16 | $18,360.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $829.00 / $1,041.08 / $1,654.79
| Facility | | $829.00 | $1,041.08 | $1,654.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $120.45 / $155.26 / $221.96
| Facility | AS | $120.45 | $155.26 | $221.96 |
- 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 |