- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $5,473.15 / $16,762.57
| Facility | | $1,615.00 | $5,473.15 | $16,762.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,003.91 / $9,212.06 / $17,819.09
| Facility | | $7,003.91 | $9,212.06 | $17,819.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,368.73 / $2,368.73 / $2,368.73
| Facility | | $2,368.73 | $2,368.73 | $2,368.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $420.74 / $778.37 / $5,405.32
| Facility | | $420.74 | $778.37 | $5,405.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $118.86 / $849.00 / $849.00
| Facility | AS | $118.86 | $849.00 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.82 / $1,132.48 / $2,961.89
| Facility | | $850.82 | $1,132.48 | $2,961.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |