- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.16 / $11,119.10 / $16,467.00
| Facility | | $1,000.16 | $11,119.10 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,871.40 / $9,829.40 / $18,018.52
| Facility | | $3,871.40 | $9,829.40 | $18,018.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $991.71 / $2,345.00 / $7,594.59
| Facility | | $991.71 | $2,345.00 | $7,594.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $98.50 / $98.50 / $98.50
| Facility | AS | $98.50 | $98.50 | $98.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.81 / $1,222.54 / $1,920.91
| Facility | | $976.81 | $1,222.54 | $1,920.91 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.85 / $175.56 / $257.58
| Facility | AS | $147.85 | $175.56 | $257.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |