- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.46 / $5,611.88 / $8,413.00
| Facility | | $720.46 | $5,611.88 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,062.80
| Facility | | $606.10 | $606.10 | $2,062.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $720.46 / $944.83 / $1,383.28
| Facility | | $720.46 | $944.83 | $1,383.28 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $132.28 / $132.28 / $238.04
| Facility | AS | $132.28 | $132.28 | $238.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,950.27 / $6,817.20
| Facility | | $55.00 | $5,950.27 | $6,817.20 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $165.45 / $388.48 / $646.16
| Facility | AS | $165.45 | $388.48 | $646.16 |