- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.02 / $9,062.00 / $18,276.00
| Facility | | $549.02 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,182.37 / $12,097.16
| Facility | | $3,366.50 | $7,182.37 | $12,097.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.79 / $715.00 / $2,581.96
| Facility | | $549.79 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $54.47 / $54.47 / $54.47
| Facility | AS | $54.47 | $54.47 | $54.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.62 / $664.31 / $1,041.67
| Facility | | $530.62 | $664.31 | $1,041.67 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $78.25 / $93.52 / $138.96
| Facility | AS | $78.25 | $93.52 | $138.96 |
- 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 |