- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,270.21 / $5,239.08 / $16,467.00
| Facility | | $2,270.21 | $5,239.08 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $763.74 / $763.74 / $1,438.15
| Facility | | $763.74 | $763.74 | $1,438.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $2,219.06
| Facility | | $890.00 | $890.00 | $2,219.06 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.70 / $218.70 / $218.70
| Facility | AS | $218.70 | $218.70 | $218.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,162.35 / $2,648.00 / $4,345.14
| Facility | | $2,162.35 | $2,648.00 | $4,345.14 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $313.74 / $370.72 / $584.22
| Facility | AS | $313.74 | $370.72 | $584.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,471.00 / $5,871.00 / $8,973.00
| Facility | | $1,471.00 | $5,871.00 | $8,973.00 |