- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.42 / $6,953.60 / $10,804.49
| Facility | | $735.42 | $6,953.60 | $10,804.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $6,025.59
| Facility | | $748.70 | $748.70 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $735.42 / $957.00 / $1,498.00
| Facility | | $735.42 | $957.00 | $1,498.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $128.43 / $133.97 / $232.69
| Facility | AS | $128.43 | $133.97 | $232.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,827.20 / $19,913.50 / $26,542.00
| Facility | | $2,827.20 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.79 / $1,134.79 / $1,887.52
| Facility | AS | $171.79 | $1,134.79 | $1,887.52 |