- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.00 / $3,607.94 / $13,401.00
| Facility | | $803.00 | $3,607.94 | $13,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,252.30 / $3,787.86 / $11,751.55
| Facility | | $2,252.30 | $3,787.86 | $11,751.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.10 / $1,023.10 / $2,080.26
| Facility | | $1,023.10 | $1,023.10 | $2,080.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55.00 / $52,504.62
| Facility | | $55.00 | $55.00 | $52,504.62 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $497.28 / $1,013.95 / $1,056.54
| Facility | AS | $497.28 | $1,013.95 | $1,056.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,316.21 / $2,989.11 / $5,018.91
| Facility | | $2,316.21 | $2,989.11 | $5,018.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,316.21 / $3,011.07 / $5,708.94
| Facility | | $2,316.21 | $3,011.07 | $5,708.94 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $385.00 / $2,064.00 / $8,759.00
| Facility | | $385.00 | $2,064.00 | $8,759.00 |