- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $960.88 / $1,476.33 / $8,413.00
| Facility | | $960.88 | $1,476.33 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.86 / $3,066.86 / $4,382.17
| Facility | | $3,066.86 | $3,066.86 | $4,382.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $960.89 / $1,262.82 / $1,928.59
| Facility | | $960.89 | $1,262.82 | $1,928.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $153.02 / $203.42 / $304.02
| Facility | AS | $153.02 | $203.42 | $304.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,306.00 / $10,968.00 / $17,120.00
| Facility | | $3,306.00 | $10,968.00 | $17,120.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,736.24 / $19,913.50 / $26,542.00
| Facility | | $3,736.24 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $228.98 / $1,134.79 / $1,887.52
| Facility | AS | $228.98 | $1,134.79 | $1,887.52 |