- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,243.64 / $9,062.00 / $18,276.00
| Facility | | $1,243.64 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,049.08 / $14,347.55 / $25,563.66
| Facility | | $7,049.08 | $14,347.55 | $25,563.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $1,100.00 / $14,684.91
| Facility | | $715.00 | $1,100.00 | $14,684.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.40 / $122.40 / $122.40
| Facility | AS | $122.40 | $122.40 | $122.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,199.64 / $1,490.00 / $2,381.51
| Facility | | $1,199.64 | $1,490.00 | $2,381.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $180.32 / $218.26 / $319.02
| Facility | AS | $180.32 | $218.26 | $319.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |