- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,511.94 / $3,617.00 / $7,467.00
| Facility | | $1,511.94 | $3,617.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,531.19 / $4,140.09
| Facility | | $672.35 | $2,531.19 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $744.80 / $1,099.53 / $7,168.00
| Facility | | $744.80 | $1,099.53 | $7,168.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $198.71 / $198.71 / $2,614.82
| Facility | AS | $198.71 | $198.71 | $2,614.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,637.00 / $6,477.00 / $9,010.00
| Facility | | $4,637.00 | $6,477.00 | $9,010.00 |