- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $482.12 / $5,611.88 / $10,134.00
| Facility | | $482.12 | $5,611.88 | $10,134.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,297.06 / $2,297.06 / $2,330.58
| Facility | | $2,297.06 | $2,297.06 | $2,330.58 |
- 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
- $482.12 / $604.00 / $995.38
| Facility | | $482.12 | $604.00 | $995.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.76 / $84.56 / $152.54
| Facility | AS | $83.76 | $84.56 | $152.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,248.00 / $9,541.00 / $14,589.00
| Facility | | $2,248.00 | $9,541.00 | $14,589.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,337.80 / $8,957.00 / $26,542.00
| Facility | | $2,337.80 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.30 / $510.42 / $849.00
| Facility | AS | $114.30 | $510.42 | $849.00 |