- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $813.38 / $1,294.61 / $8,413.00
| Facility | | $813.38 | $1,294.61 | $8,413.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,282.04 / $9,282.04 / $9,417.48
| Facility | | $9,282.04 | $9,282.04 | $9,417.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $606.10
| Facility | | $606.10 | $606.10 | $606.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $813.38 / $1,016.89 / $1,654.66
| Facility | | $813.38 | $1,016.89 | $1,654.66 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $139.58 / $142.36 / $257.35
| Facility | AS | $139.58 | $142.36 | $257.35 |
- 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 / $6,673.94 / $6,673.94
| Facility | | $55.00 | $6,673.94 | $6,673.94 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $116.89 / $211.91 / $418.49
| Facility | AS | $116.89 | $211.91 | $418.49 |