- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,758.00 / $7,467.00
| Facility | | $1,671.00 | $3,758.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.35 / $2,211.19 / $3,616.69
| Facility | | $587.35 | $2,211.19 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $668.56 / $910.51 / $3,911.00
| Facility | | $668.56 | $910.51 | $3,911.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $176.86 / $176.86 / $646.16
| Facility | AS | $176.86 | $176.86 | $646.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |