- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $981.83 / $7,808.40 / $55,974.31
| Facility | | $981.83 | $7,808.40 | $55,974.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $810.13 / $1,107.93 / $1,674.81
| Facility | | $810.13 | $1,107.93 | $1,674.81 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $137.72 / $155.11 / $277.72
| Facility | AS | $137.72 | $155.11 | $277.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,216.00 / $30,820.00 / $59,455.00
| Facility | | $16,216.00 | $30,820.00 | $59,455.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $4,643.16 / $146,520.65
| Facility | | $55.00 | $4,643.16 | $146,520.65 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $190.58 / $13,888.08 / $13,888.08
| Facility | AS | $190.58 | $13,888.08 | $13,888.08 |