- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.06 / $1,245.00 / $10,561.00
| Facility | | $717.06 | $1,245.00 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $8,235.09
| Facility | | $748.70 | $748.70 | $8,235.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $717.06 / $1,014.00 / $1,546.08
| Facility | | $717.06 | $1,014.00 | $1,546.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $126.28 / $141.96 / $226.88
| Facility | AS | $126.28 | $141.96 | $226.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,317.00 / $13,946.00 / $21,454.00
| Facility | | $4,317.00 | $13,946.00 | $21,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,758.60 / $26,542.00 / $27,215.50
| Facility | | $2,758.60 | $26,542.00 | $27,215.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $168.45 / $1,550.91 / $2,579.65
| Facility | AS | $168.45 | $1,550.91 | $2,579.65 |