- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.86 / $764.54 / $7,278.00
| Facility | | $409.86 | $764.54 | $7,278.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.83 / $1,704.83 / $1,729.70
| Facility | | $1,704.83 | $1,704.83 | $1,729.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $530.04 / $530.04 / $2,710.28
| Facility | | $530.04 | $530.04 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $409.86 / $697.51 / $1,062.25
| Facility | | $409.86 | $697.51 | $1,062.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $80.25 / $118.44 / $154.60
| Facility | AS | $80.25 | $118.44 | $154.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,661.00 / $7,659.00 / $10,502.00
| Facility | | $1,661.00 | $7,659.00 | $10,502.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,947.32 / $2,154.03 / $16,394.00
| Facility | | $1,947.32 | $2,154.03 | $16,394.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $109.61 / $215.40 / $215.40
| Facility | AS | $109.61 | $215.40 | $215.40 |