- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $985.12 / $14,455.32 / $18,912.09
| Facility | | $985.12 | $14,455.32 | $18,912.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.08 / $15,089.42 / $25,571.79
| Facility | | $7,049.08 | $15,089.42 | $25,571.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $975.72 / $14,357.40
| Facility | | $715.00 | $975.72 | $14,357.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $97.05 / $97.05 / $97.05
| Facility | AS | $97.05 | $97.05 | $97.05 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $954.60 / $1,196.27 / $1,888.90
| Facility | | $954.60 | $1,196.27 | $1,888.90 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.72 / $171.78 / $252.63
| Facility | AS | $144.72 | $171.78 | $252.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,628.00 / $17,146.00 / $24,161.00
| Facility | | $4,628.00 | $17,146.00 | $24,161.00 |