- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $957.78 / $9,062.00 / $18,276.00
| Facility | | $957.78 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,154.44 / $6,537.29 / $11,190.33
| Facility | | $3,154.44 | $6,537.29 | $11,190.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $945.10 / $5,740.31
| Facility | | $715.00 | $945.10 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $94.51 / $94.51 / $94.51
| Facility | AS | $94.51 | $94.51 | $94.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $856.53 / $1,113.31 / $1,709.70
| Facility | | $856.53 | $1,113.31 | $1,709.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.84 / $167.61 / $227.56
| Facility | AS | $112.84 | $167.61 | $227.56 |
- 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 |