- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $776.25 / $7,724.00 / $18,218.57
| Facility | | $776.25 | $7,724.00 | $18,218.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,221.47 / $3,221.47 / $4,603.08
| Facility | | $3,221.47 | $3,221.47 | $4,603.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $7,667.90
| Facility | | $606.10 | $606.10 | $7,667.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.12 / $918.24 / $1,394.08
| Facility | | $656.12 | $918.24 | $1,394.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $113.13 / $157.88 / $207.60
| Facility | AS | $113.13 | $157.88 | $207.60 |
- 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
- $2,537.04 / $25,341.00 / $26,542.00
| Facility | | $2,537.04 | $25,341.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $154.93 / $1,444.09 / $2,401.96
| Facility | AS | $154.93 | $1,444.09 | $2,401.96 |