- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.35 / $8,477.27 / $20,928.72
| Facility | | $870.35 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- 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
- $669.50 / $1,205.09 / $7,276.00
| Facility | | $669.50 | $1,205.09 | $7,276.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $188.63 / $849.00 / $849.00
| Facility | AS | $188.63 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,285.00 / $1,678.13 / $2,961.89
| Facility | | $1,285.00 | $1,678.13 | $2,961.89 |
- 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 |