- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,631.79 / $4,474.00 / $7,562.14
| Facility | | $1,631.79 | $4,474.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $944.35 / $3,688.52 / $5,814.97
| Facility | | $944.35 | $3,688.52 | $5,814.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $801.83 / $1,086.46 / $9,251.00
| Facility | | $801.83 | $1,086.46 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $214.46 / $214.46 / $2,561.40
| Facility | AS | $214.46 | $214.46 | $2,561.40 |
- 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 |