- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $4,521.00 / $10,407.00
| Facility | | $2,073.00 | $4,521.00 | $10,407.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,640.00 / $10,860.55
| Facility | | $1,763.75 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,389.63 / $1,843.58 / $9,437.00
| Facility | | $1,389.63 | $1,843.58 | $9,437.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $364.79 / $364.79 / $686.82
| Facility | AS | $364.79 | $364.79 | $686.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,279.00 / $7,341.00 / $11,396.00
| Facility | | $5,279.00 | $7,341.00 | $11,396.00 |