- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,785.00 / $7,562.14
| Facility | | $1,671.00 | $3,785.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.17 / $2,717.09 / $4,193.09
| Facility | | $688.17 | $2,717.09 | $4,193.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $656.61 / $902.03 / $9,383.00
| Facility | | $656.61 | $902.03 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $185.90 / $185.90 / $2,478.67
| Facility | AS | $185.90 | $185.90 | $2,478.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,607.00 / $7,702.00 / $11,396.00
| Facility | | $5,607.00 | $7,702.00 | $11,396.00 |