- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,074.57 / $9,062.00 / $18,276.00
| Facility | | $1,074.57 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,902.15 / $7,355.47 / $12,492.30
| Facility | | $3,902.15 | $7,355.47 | $12,492.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,207.14 / $1,207.14 / $2,345.00
| Facility | | $1,207.14 | $1,207.14 | $2,345.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $119.75 / $119.75 / $119.75
| Facility | AS | $119.75 | $119.75 | $119.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $903.34 / $1,119.26 / $2,343.38
| Facility | | $903.34 | $1,119.26 | $2,343.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.01 / $128.97 / $201.04
| Facility | AS | $125.01 | $128.97 | $201.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |