- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.48 / $5,872.81 / $10,124.57
| Facility | | $705.48 | $5,872.81 | $10,124.57 |
- 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 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $705.48 / $938.63 / $1,408.19
| Facility | | $705.48 | $938.63 | $1,408.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.10 / $161.97 / $223.21
| Facility | AS | $122.10 | $161.97 | $223.21 |
- 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
- $2,718.08 / $19,913.50 / $26,542.00
| Facility | | $2,718.08 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $166.33 / $1,134.79 / $1,887.52
| Facility | AS | $166.33 | $1,134.79 | $1,887.52 |