- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.34 / $1,294.89 / $14,636.12
| Facility | | $825.34 | $1,294.89 | $14,636.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,863.39 / $1,863.39 / $2,662.55
| Facility | | $1,863.39 | $1,863.39 | $2,662.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,182.48 / $1,182.48 / $3,502.79
| Facility | | $1,182.48 | $1,182.48 | $3,502.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $825.34 / $1,076.00 / $1,724.03
| Facility | | $825.34 | $1,076.00 | $1,724.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $134.38 / $168.00 / $261.14
| Facility | AS | $134.38 | $168.00 | $261.14 |
- 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
- $3,108.08 / $11,576.10 / $26,542.00
| Facility | | $3,108.08 | $11,576.10 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $192.02 / $659.68 / $1,097.25
| Facility | AS | $192.02 | $659.68 | $1,097.25 |