- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $699.06 / $9,062.00 / $16,467.00
| Facility | | $699.06 | $9,062.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,366.50 / $7,206.40 / $12,212.57
| Facility | | $3,366.50 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $698.59 / $2,581.96
| Facility | | $580.00 | $698.59 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $69.16 / $69.16 / $69.16
| Facility | AS | $69.16 | $69.16 | $69.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.06 / $851.00 / $1,326.88
| Facility | | $670.06 | $851.00 | $1,326.88 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.13 / $119.14 / $176.47
| Facility | AS | $100.13 | $119.14 | $176.47 |
- 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 |