- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.15 / $1,159.44 / $7,362.00
| Facility | | $441.15 | $1,159.44 | $7,362.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,092.08 / $3,092.08 / $3,137.19
| Facility | | $3,092.08 | $3,092.08 | $3,137.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $8,855.06
| Facility | | $606.10 | $606.10 | $8,855.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.15 / $994.10 / $1,341.28
| Facility | | $441.15 | $994.10 | $1,341.28 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $118.22 / $144.59 / $221.47
| Facility | AS | $118.22 | $144.59 | $221.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $3,084.84 / $3,084.84
| Facility | | $55.00 | $3,084.84 | $3,084.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $115.19 / $222.36 / $222.36
| Facility | AS | $115.19 | $222.36 | $222.36 |