- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.66 / $1,635.00 / $8,442.00
| Facility | | $637.66 | $1,635.00 | $8,442.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,066.86 / $3,066.86 / $4,382.17
| Facility | | $3,066.86 | $3,066.86 | $4,382.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $8,031.82
| Facility | | $748.70 | $748.70 | $8,031.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.66 / $835.00 / $1,301.00
| Facility | | $637.66 | $835.00 | $1,301.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $103.67 / $116.90 / $207.20
| Facility | AS | $103.67 | $116.90 | $207.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,442.88 / $26,542.00 / $26,543.70
| Facility | | $2,442.88 | $26,542.00 | $26,543.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $150.05 / $1,512.62 / $2,515.96
| Facility | AS | $150.05 | $1,512.62 | $2,515.96 |