- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.40 / $1,245.00 / $7,278.00
| Facility | | $826.40 | $1,245.00 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,226.87 / $2,226.87 / $2,259.36
| Facility | | $2,226.87 | $2,226.87 | $2,259.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.40 / $1,059.90 / $1,767.39
| Facility | | $826.40 | $1,059.90 | $1,767.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $118.72 / $187.60 / $261.47
| Facility | AS | $118.72 | $187.60 | $261.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,094.16 / $8,957.00 / $16,394.00
| Facility | | $3,094.16 | $8,957.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.86 / $510.42 / $849.00
| Facility | AS | $191.86 | $510.42 | $849.00 |