- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,098.06 / $1,098.06 / $7,859.00
| Facility | | $1,098.06 | $1,098.06 | $7,859.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,212.74 / $22,897.69 / $46,771.99
| Facility | | $5,212.74 | $22,897.69 | $46,771.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,662.71 / $3,778.00 / $9,088.49
| Facility | | $2,662.71 | $3,778.00 | $9,088.49 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $124.78 / $124.78 / $124.78
| Facility | AS | $124.78 | $124.78 | $124.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,420.64 / $3,454.00 / $7,156.29
| Facility | | $2,420.64 | $3,454.00 | $7,156.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,142.41 / $1,881.67 / $3,310.98
| Facility | | $1,142.41 | $1,881.67 | $3,310.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $284.12 / $284.12 / $284.12
| Facility | AS | $284.12 | $284.12 | $284.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $9,370.00 / $12,774.00
| Facility | | $5,457.00 | $9,370.00 | $12,774.00 |