- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,199.72 / $7,401.48 / $11,124.00
| Facility | | $1,199.72 | $7,401.48 | $11,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $6,025.59 / $13,652.00
| Facility | | $606.10 | $6,025.59 | $13,652.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,199.72 / $1,493.00 / $2,704.00
| Facility | | $1,199.72 | $1,493.00 | $2,704.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $186.48 / $209.02 / $379.59
| Facility | AS | $186.48 | $209.02 | $379.59 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,870.00 / $22,780.00
| Facility | | $4,015.00 | $15,870.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,897.00 / $17,381.18 / $19,913.50
| Facility | | $5,897.00 | $17,381.18 | $19,913.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $268.25 / $1,134.79 / $1,887.52
| Facility | AS | $268.25 | $1,134.79 | $1,887.52 |