- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $680.20 / $5,850.94 / $10,439.54
| Facility | | $680.20 | $5,850.94 | $10,439.54 |
- 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
- $748.70 / $748.70 / $2,710.28
| Facility | | $748.70 | $748.70 | $2,710.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $485.86 / $694.46 / $1,187.93
| Facility | | $485.86 | $694.46 | $1,187.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $84.16 / $113.26 / $180.71
| Facility | AS | $84.16 | $113.26 | $180.71 |
- 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
- $2,344.65 / $8,957.00 / $33,500.00
| Facility | | $2,344.65 | $8,957.00 | $33,500.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.42 / $510.42 / $849.00
| Facility | AS | $114.42 | $510.42 | $849.00 |