- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.06 / $9,062.00 / $18,276.00
| Facility | | $842.06 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,714.49 / $19,041.73 / $34,283.46
| Facility | | $7,714.49 | $19,041.73 | $34,283.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $835.85 / $7,845.21
| Facility | | $715.00 | $835.85 | $7,845.21 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $82.88 / $82.88 / $82.88
| Facility | AS | $82.88 | $82.88 | $82.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.15 / $1,018.37 / $1,602.92
| Facility | | $812.15 | $1,018.37 | $1,602.92 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.75 / $154.84 / $214.18
| Facility | AS | $123.75 | $154.84 | $214.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,766.00 / $17,146.00 / $24,729.00
| Facility | | $8,766.00 | $17,146.00 | $24,729.00 |