- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.50 / $2,778.00 / $8,413.00
| Facility | | $482.50 | $2,778.00 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.50 / $656.57 / $969.06
| Facility | | $482.50 | $656.57 | $969.06 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.25 / $100.38 / $152.66
| Facility | AS | $83.25 | $100.38 | $152.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,874.60 / $8,957.00 / $26,542.00
| Facility | | $1,874.60 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $115.09 / $510.42 / $849.00
| Facility | AS | $115.09 | $510.42 | $849.00 |