- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.53 / $1,843.14 / $19,153.58
| Facility | | $1,163.53 | $1,843.14 | $19,153.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,807.46 / $6,807.46 / $6,906.79
| Facility | | $6,807.46 | $6,807.46 | $6,906.79 |
- 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
- $1,163.53 / $1,420.69 / $2,496.00
| Facility | | $1,163.53 | $1,420.69 | $2,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $178.22 / $198.90 / $368.14
| Facility | AS | $178.22 | $198.90 | $368.14 |
- 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
- $262.16 / $1,134.79 / $1,887.52
| Facility | AS | $262.16 | $1,134.79 | $1,887.52 |