- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $581.02 / $9,062.00 / $18,276.00
| Facility | | $581.02 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $6,852.09 / $12,097.16
| Facility | | $3,366.50 | $6,852.09 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $579.54 / $715.00 / $2,581.96
| Facility | | $579.54 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $57.49 / $57.49 / $57.49
| Facility | AS | $57.49 | $57.49 | $57.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $556.41 / $697.22 / $1,096.58
| Facility | | $556.41 | $697.22 | $1,096.58 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $82.30 / $98.42 / $145.78
| Facility | AS | $82.30 | $98.42 | $145.78 |
- 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 |