- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,597.16 / $2,032.86 / $7,439.00
| Facility | | $1,597.16 | $2,032.86 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,016.00 / $2,294.10 / $5,001.76
| Facility | | $2,016.00 | $2,294.10 | $5,001.76 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $282.24 / $286.41 / $700.25
| Facility | AS | $282.24 | $286.41 | $700.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.00 / $3,906.00 / $6,388.00
| Facility | | $1,064.00 | $3,906.00 | $6,388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $40,107.69 / $48,344.52
| Facility | | $55.00 | $40,107.69 | $48,344.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $458.67 / $501.58 / $971.38
| Facility | AS | $458.67 | $501.58 | $971.38 |