- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.87 / $7,015.11 / $10,034.00
| Facility | | $1,400.87 | $7,015.11 | $10,034.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $6,025.59
| Facility | | $606.10 | $606.10 | $6,025.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.71 / $1,371.48 / $1,920.08
| Facility | | $976.71 | $1,371.48 | $1,920.08 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $187.80 / $192.01 / $322.70
| Facility | AS | $187.80 | $192.01 | $322.70 |
- 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
- $1,400.00 / $17,381.18 / $19,913.50
| Facility | | $1,400.00 | $17,381.18 | $19,913.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $226.14 / $1,134.79 / $1,887.52
| Facility | AS | $226.14 | $1,134.79 | $1,887.52 |