- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $760.13 / $3,627.00 / $8,577.01
| Facility | | $760.13 | $3,627.00 | $8,577.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,431.95 / $7,827.00 / $19,139.18
| Facility | | $6,431.95 | $7,827.00 | $19,139.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.22 / $759.22 / $759.22
| Facility | | $759.22 | $759.22 | $759.22 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $75.45 / $75.45 / $75.45
| Facility | AS | $75.45 | $75.45 | $75.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,151.83 / $6,477.48 / $12,159.11
| Facility | | $3,151.83 | $6,477.48 | $12,159.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $761.33 / $3,838.00 / $8,435.43
| Facility | | $761.33 | $3,838.00 | $8,435.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $759.22 / $759.22 / $759.22
| Facility | | $759.22 | $759.22 | $759.22 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $75.45 / $75.45 / $75.45
| Facility | AS | $75.45 | $75.45 | $75.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.11 / $652.11 / $709.08
| Facility | | $652.11 | $652.11 | $709.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $4,476.00 / $10,443.12
| Facility | | $2,332.00 | $4,476.00 | $10,443.12 |