- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.92 / $1,353.40 / $10,924.00
| Facility | | $826.92 | $1,353.40 | $10,924.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,185.50 / $3,185.50 / $3,231.98
| Facility | | $3,185.50 | $3,185.50 | $3,231.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.10 / $852.10 / $3,435.20
| Facility | | $852.10 | $852.10 | $3,435.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.92 / $1,029.41 / $1,702.82
| Facility | | $826.92 | $1,029.41 | $1,702.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $143.50 / $144.12 / $261.64
| Facility | AS | $143.50 | $144.12 | $261.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,182.80 / $11,352.75 / $26,542.00
| Facility | | $3,182.80 | $11,352.75 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.16 / $646.95 / $1,076.08
| Facility | AS | $194.16 | $646.95 | $1,076.08 |