- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $564.87 / $1,020.00 / $10,661.00
| Facility | | $564.87 | $1,020.00 | $10,661.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,403.26 / $4,403.26 / $4,467.51
| Facility | | $4,403.26 | $4,403.26 | $4,467.51 |
- 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
- $582.49 / $818.65 / $1,259.83
| Facility | | $582.49 | $818.65 | $1,259.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.80 / $134.96 / $184.30
| Facility | AS | $100.80 | $134.96 | $184.30 |
- 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
- $3,359.22 / $8,957.00 / $26,542.00
| Facility | | $3,359.22 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $136.55 / $510.42 / $849.00
| Facility | AS | $136.55 | $510.42 | $849.00 |