- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.28 / $3,508.40 / $16,467.00
| Facility | | $1,020.28 | $3,508.40 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $17,635.50 / $63,570.63 / $110,522.36
| Facility | | $17,635.50 | $63,570.63 | $110,522.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $33,450.18 / $33,450.18 / $42,984.09
| Facility | | $33,450.18 | $33,450.18 | $42,984.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $747.00 / $997.57 / $1,894.13
| Facility | | $747.00 | $997.57 | $1,894.13 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $120.54 / $132.40 / $265.18
| Facility | AS | $120.54 | $132.40 | $265.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,200.00 / $30,490.00 / $77,327.00
| Facility | | $4,200.00 | $30,490.00 | $77,327.00 |