- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $865.91 / $8,783.00 / $16,639.00
| Facility | | $865.91 | $8,783.00 | $16,639.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,565.74 / $18,669.81 / $34,283.46
| Facility | | $6,565.74 | $18,669.81 | $34,283.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $846.52 / $7,790.73
| Facility | | $580.00 | $846.52 | $7,790.73 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $84.30 / $84.30 / $84.30
| Facility | AS | $84.30 | $84.30 | $84.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.31 / $1,047.75 / $1,657.83
| Facility | | $832.31 | $1,047.75 | $1,657.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $126.86 / $150.91 / $222.32
| Facility | AS | $126.86 | $150.91 | $222.32 |
- 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 |