- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $666.75 / $9,062.00 / $18,276.00
| Facility | | $666.75 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $6,861.51 / $11,947.84
| Facility | | $3,294.50 | $6,861.51 | $11,947.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $665.85 / $1,100.00 / $2,581.96
| Facility | | $665.85 | $1,100.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $66.06 / $66.06 / $66.06
| Facility | AS | $66.06 | $66.06 | $66.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.00 / $767.19 / $1,265.10
| Facility | | $596.00 | $767.19 | $1,265.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.44 / $116.06 / $168.64
| Facility | AS | $83.44 | $116.06 | $168.64 |
- 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 |