- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.48 / $6,151.65 / $10,453.00
| Facility | | $476.48 | $6,151.65 | $10,453.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $476.48 / $657.63 / $952.12
| Facility | | $476.48 | $657.63 | $952.12 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $81.22 / $93.24 / $150.76
| Facility | AS | $81.22 | $93.24 | $150.76 |
- 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
- $2,316.00 / $8,957.00 / $26,542.00
| Facility | | $2,316.00 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $113.20 / $510.42 / $849.00
| Facility | AS | $113.20 | $510.42 | $849.00 |