- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.24 / $7,963.23 / $16,467.00
| Facility | | $901.24 | $7,963.23 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,468.66 / $6,420.48 / $11,041.04
| Facility | | $2,468.66 | $6,420.48 | $11,041.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $818.00 / $1,081.49 / $1,612.09
| Facility | | $818.00 | $1,081.49 | $1,612.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $116.34 / $177.38 / $214.57
| Facility | AS | $116.34 | $177.38 | $214.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |