- 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
- $587.35 / $2,211.19 / $3,616.69
| Facility | | $587.35 | $2,211.19 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $527.14 / $725.20 / $3,787.00
| Facility | | $527.14 | $725.20 | $3,787.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $142.76 / $142.76 / $380.79
| Facility | AS | $142.76 | $142.76 | $380.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,132.00 / $3,365.00 / $5,307.00
| Facility | | $2,132.00 | $3,365.00 | $5,307.00 |