- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $878.31 / $2,037.39 / $16,467.00
| Facility | | $878.31 | $2,037.39 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,492.30
| Facility | | $3,366.50 | $7,206.40 | $12,492.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $873.79 / $5,740.31
| Facility | | $715.00 | $873.79 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $86.87 / $86.87 / $86.87
| Facility | AS | $86.87 | $86.87 | $86.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.14 / $1,062.76 / $1,675.37
| Facility | | $849.14 | $1,062.76 | $1,675.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $127.82 / $150.22 / $224.12
| Facility | AS | $127.82 | $150.22 | $224.12 |
- 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 |