- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.60 / $892.91 / $8,413.00
| Facility | | $515.60 | $892.91 | $8,413.00 |
- 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
- $606.10 / $606.10 / $2,710.28
| Facility | | $606.10 | $606.10 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $515.60 / $815.74 / $1,246.19
| Facility | | $515.60 | $815.74 | $1,246.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $94.34 / $119.56 / $189.14
| Facility | AS | $94.34 | $119.56 | $189.14 |
- 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
- $2,483.00 / $2,722.80 / $26,542.00
| Facility | | $2,483.00 | $2,722.80 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $139.55 / $272.27 / $272.27
| Facility | AS | $139.55 | $272.27 | $272.27 |