- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.60 / $8,355.33 / $19,276.96
| Facility | | $526.60 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,851.10 / $6,851.10 / $6,851.10
| Facility | | $6,851.10 | $6,851.10 | $6,851.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $526.60 / $947.88 / $9,696.00
| Facility | | $526.60 | $947.88 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $148.13 / $2,455.55 / $2,455.55
| Facility | AS | $148.13 | $2,455.55 | $2,455.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,055.00 / $1,318.09 / $8,623.62
| Facility | | $1,055.00 | $1,318.09 | $8,623.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |