- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $655.33 / $6,858.15 / $7,993.00
| Facility | | $655.33 | $6,858.15 | $7,993.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,503.36 / $2,503.36 / $2,539.89
| Facility | | $2,503.36 | $2,503.36 | $2,539.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $596.95 / $827.08 / $1,205.71
| Facility | | $596.95 | $827.08 | $1,205.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $102.30 / $125.58 / $188.87
| Facility | AS | $102.30 | $125.58 | $188.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,459.42 / $8,957.00 / $26,542.00
| Facility | | $3,459.42 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $140.38 / $510.42 / $849.00
| Facility | AS | $140.38 | $510.42 | $849.00 |