- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,819.00 / $7,467.00
| Facility | | $1,671.00 | $3,819.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,613.46 / $4,140.09
| Facility | | $672.35 | $2,613.46 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $808.76 / $1,069.68 / $9,251.00
| Facility | | $808.76 | $1,069.68 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $215.38 / $215.38 / $4,562.51
| Facility | AS | $215.38 | $215.38 | $4,562.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,408.00 / $7,457.00 / $11,396.00
| Facility | | $5,408.00 | $7,457.00 | $11,396.00 |