- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.54 / $1,410.00 / $12,615.00
| Facility | | $845.54 | $1,410.00 | $12,615.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,736.14 / $5,736.14 / $8,196.23
| Facility | | $5,736.14 | $5,736.14 | $8,196.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $852.10 / $852.10 / $14,818.47
| Facility | | $852.10 | $852.10 | $14,818.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $845.54 / $1,074.00 / $1,762.47
| Facility | | $845.54 | $1,074.00 | $1,762.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $148.50 / $150.36 / $267.52
| Facility | AS | $148.50 | $150.36 | $267.52 |
- 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
- $3,269.12 / $42,744.76 / $48,972.40
| Facility | | $3,269.12 | $42,744.76 | $48,972.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $199.70 / $2,790.74 / $4,641.89
| Facility | AS | $199.70 | $2,790.74 | $4,641.89 |