- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,163.02 / $3,174.50 / $8,631.64
| Facility | | $1,163.02 | $3,174.50 | $8,631.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,977.00 / $9,098.00 / $16,411.00
| Facility | | $4,977.00 | $9,098.00 | $16,411.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,281.49 / $2,000.36 / $9,237.98
| Facility | | $1,281.49 | $2,000.36 | $9,237.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $127.09 / $127.09 / $127.09
| Facility | AS | $127.09 | $127.09 | $127.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $5,111.00 / $9,202.00
| Facility | | $2,200.00 | $5,111.00 | $9,202.00 |