- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.87 / $3,251.07 / $10,134.00
| Facility | | $525.87 | $3,251.07 | $10,134.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $525.87 / $666.00 / $1,188.47
| Facility | | $525.87 | $666.00 | $1,188.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $92.12 / $93.24 / $179.08
| Facility | AS | $92.12 | $93.24 | $179.08 |
- 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
- $3,025.38 / $19,913.50 / $26,542.00
| Facility | | $3,025.38 | $19,913.50 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.16 / $1,134.79 / $1,887.52
| Facility | AS | $123.16 | $1,134.79 | $1,887.52 |