- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.95 / $10,431.19 / $20,928.72
| Facility | | $657.95 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,952.65 / $9,144.62 / $17,688.66
| Facility | | $6,952.65 | $9,144.62 | $17,688.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $657.95 / $1,151.41 / $5,405.32
| Facility | | $657.95 | $1,151.41 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $185.94 / $849.00 / $849.00
| Facility | AS | $185.94 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,333.31 / $1,775.85 / $3,000.40
| Facility | | $1,333.31 | $1,775.85 | $3,000.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |