- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $477.73 / $8,783.00 / $16,639.00
| Facility | | $477.73 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,088.76 / $5,005.09 / $9,195.94
| Facility | | $2,088.76 | $5,005.09 | $9,195.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $478.00 / $1,158.06 / $2,345.00
| Facility | | $478.00 | $1,158.06 | $2,345.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $47.39 / $47.39 / $47.39
| Facility | AS | $47.39 | $47.39 | $47.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $456.24 / $522.35 / $913.57
| Facility | | $456.24 | $522.35 | $913.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $71.65 / $71.65 / $121.60
| Facility | AS | $71.65 | $71.65 | $121.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,147.00 / $16,249.00
| Facility | | $1,550.00 | $10,147.00 | $16,249.00 |