- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,182.00 / $7,960.15
| Facility | | $1,671.00 | $4,182.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,228.01 / $5,113.62
| Facility | | $830.45 | $3,228.01 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $850.00 / $1,129.28 / $9,251.00
| Facility | | $850.00 | $1,129.28 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $226.16 / $226.16 / $4,657.58
| Facility | AS | $226.16 | $226.16 | $4,657.58 |
- 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 |