- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.86 / $1,069.47 / $10,561.00
| Facility | | $675.86 | $1,069.47 | $10,561.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,855.05 / $6,855.05 / $6,955.07
| Facility | | $6,855.05 | $6,855.05 | $6,955.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.70 / $748.70 / $16,312.47
| Facility | | $748.70 | $748.70 | $16,312.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $675.86 / $952.83 / $1,399.92
| Facility | | $675.86 | $952.83 | $1,399.92 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $118.91 / $140.84 / $213.84
| Facility | AS | $118.91 | $140.84 | $213.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,232.35 / $47,054.31 / $53,909.80
| Facility | | $3,232.35 | $47,054.31 | $53,909.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $157.82 / $3,072.11 / $5,109.89
| Facility | AS | $157.82 | $3,072.11 | $5,109.89 |