- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $908.45 / $7,439.00 / $17,555.68
| Facility | | $908.45 | $7,439.00 | $17,555.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $15,392.12
| Facility | | $748.70 | $748.70 | $15,392.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $908.45 / $1,121.16 / $1,806.50
| Facility | | $908.45 | $1,121.16 | $1,806.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $143.78 / $157.87 / $287.43
| Facility | AS | $143.78 | $157.87 | $287.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,363.05 / $44,399.49 / $50,868.20
| Facility | | $4,363.05 | $44,399.49 | $50,868.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $211.89 / $2,898.78 / $4,821.58
| Facility | AS | $211.89 | $2,898.78 | $4,821.58 |