- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.06 / $1,615.00 / $10,768.00
| Facility | | $794.06 | $1,615.00 | $10,768.00 |
- 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
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.06 / $991.13 / $1,587.09
| Facility | | $794.06 | $991.13 | $1,587.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $127.82 / $138.76 / $251.24
| Facility | AS | $127.82 | $138.76 | $251.24 |
- 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
- $3,827.80 / $8,957.00 / $26,542.00
| Facility | | $3,827.80 | $8,957.00 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.37 / $510.42 / $849.00
| Facility | AS | $186.37 | $510.42 | $849.00 |