- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.95 / $1,620.58 / $10,561.00
| Facility | | $1,015.95 | $1,620.58 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $7,855.57
| Facility | | $748.70 | $748.70 | $7,855.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,015.95 / $1,564.68 / $2,296.05
| Facility | | $1,015.95 | $1,564.68 | $2,296.05 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.66 / $237.72 / $321.45
| Facility | AS | $186.66 | $237.72 | $321.45 |
- 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
- $3,891.44 / $25,961.25 / $26,542.00
| Facility | | $3,891.44 | $25,961.25 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $236.73 / $1,479.43 / $2,460.76
| Facility | AS | $236.73 | $1,479.43 | $2,460.76 |