- 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
- $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
- $875.25 / $1,160.92 / $9,383.00
| Facility | | $875.25 | $1,160.92 | $9,383.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $233.05 / $233.05 / $2,530.14
| Facility | AS | $233.05 | $233.05 | $2,530.14 |
- 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 |