- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $958.28 / $2,997.00 / $11,222.97
| Facility | | $958.28 | $2,997.00 | $11,222.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,255.79 / $5,255.79 / $5,332.48
| Facility | | $5,255.79 | $5,255.79 | $5,332.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,117.59
| Facility | | $606.10 | $606.10 | $8,117.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.00 / $1,102.04 / $1,800.39
| Facility | | $912.00 | $1,102.04 | $1,800.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $127.68 / $166.61 / $303.20
| Facility | AS | $127.68 | $166.61 | $303.20 |
- 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
- $5,481.72 / $26,542.00 / $26,827.20
| Facility | | $5,481.72 | $26,542.00 | $26,827.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $221.84 / $1,528.78 / $2,542.84
| Facility | AS | $221.84 | $1,528.78 | $2,542.84 |