- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.84 / $1,245.00 / $10,561.00
| Facility | | $727.84 | $1,245.00 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,665.09 / $3,665.09 / $3,718.57
| Facility | | $3,665.09 | $3,665.09 | $3,718.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $6,025.59
| Facility | | $748.70 | $748.70 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.84 / $972.00 / $1,486.85
| Facility | | $727.84 | $972.00 | $1,486.85 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $126.33 / $136.08 / $230.29
| Facility | AS | $126.33 | $136.08 | $230.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,183.00 / $12,216.00 / $19,066.00
| Facility | | $3,183.00 | $12,216.00 | $19,066.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,492.45 / $19,913.50 / $26,542.00
| Facility | | $3,492.45 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.76 / $1,134.79 / $1,887.52
| Facility | AS | $169.76 | $1,134.79 | $1,887.52 |