- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,207.21 / $1,880.32 / $10,561.00
| Facility | | $1,207.21 | $1,880.32 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $24,364.01
| Facility | | $748.70 | $748.70 | $24,364.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,207.21 / $1,864.00 / $2,728.29
| Facility | | $1,207.21 | $1,864.00 | $2,728.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $217.47 / $260.95 / $381.96
| Facility | AS | $217.47 | $260.95 | $381.96 |
- 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
- $6,916.20 / $70,279.48 / $80,518.70
| Facility | | $6,916.20 | $70,279.48 | $80,518.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $279.16 / $4,588.43 / $7,632.03
| Facility | AS | $279.16 | $4,588.43 | $7,632.03 |