- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $964.94 / $9,637.73 / $24,756.33
| Facility | | $964.94 | $9,637.73 | $24,756.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,182.12 / $11,253.87 / $25,424.06
| Facility | | $2,182.12 | $11,253.87 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,339.44 / $3,319.33 / $7,985.11
| Facility | | $2,339.44 | $3,319.33 | $7,985.11 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $109.68 / $109.68 / $109.68
| Facility | AS | $109.68 | $109.68 | $109.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,126.77 / $3,168.06 / $6,287.49
| Facility | | $2,126.77 | $3,168.06 | $6,287.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,041.68 / $1,992.78 / $9,892.06
| Facility | | $1,041.68 | $1,992.78 | $9,892.06 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $248.41 / $248.41 / $1,606.34
| Facility | AS | $248.41 | $248.41 | $1,606.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,457.00 / $8,579.00 / $12,774.00
| Facility | | $5,457.00 | $8,579.00 | $12,774.00 |