- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.73 / $2,074.00 / $10,308.51
| Facility | | $482.73 | $2,074.00 | $10,308.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,703.55 / $1,703.55 / $1,728.40
| Facility | | $1,703.55 | $1,703.55 | $1,728.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.73 / $700.00 / $1,059.04
| Facility | | $482.73 | $700.00 | $1,059.04 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $86.81 / $108.50 / $152.74
| Facility | AS | $86.81 | $108.50 | $152.74 |
- 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
- $1,862.20 / $8,957.00 / $16,394.00
| Facility | | $1,862.20 | $8,957.00 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $115.43 / $510.42 / $849.00
| Facility | AS | $115.43 | $510.42 | $849.00 |