- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.67 / $8,442.00 / $11,236.12
| Facility | | $641.67 | $8,442.00 | $11,236.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,221.47 / $3,221.47 / $4,603.08
| Facility | | $3,221.47 | $3,221.47 | $4,603.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $7,948.11
| Facility | | $748.70 | $748.70 | $7,948.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $641.67 / $860.00 / $1,321.00
| Facility | | $641.67 | $860.00 | $1,321.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $111.90 / $120.40 / $203.03
| Facility | AS | $111.90 | $120.40 | $203.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,652.62 / $26,267.10 / $26,542.00
| Facility | | $3,652.62 | $26,267.10 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $148.90 / $1,496.86 / $2,489.75
| Facility | AS | $148.90 | $1,496.86 | $2,489.75 |