- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,150.00 / $4,728.00 / $14,100.00
| Facility | | $1,150.00 | $4,728.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,954.18 / $11,047.74 / $17,455.31
| Facility | | $6,954.18 | $11,047.74 | $17,455.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,445.68 / $7,445.68 / $7,445.68
| Facility | | $7,445.68 | $7,445.68 | $7,445.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $787.15 / $1,024.40 / $8,986.49
| Facility | | $787.15 | $1,024.40 | $8,986.49 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $193.65 / $2,483.07 / $2,483.07
| Facility | AS | $193.65 | $2,483.07 | $2,483.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,481.00 / $5,524.00 / $9,232.95
| Facility | | $1,481.00 | $5,524.00 | $9,232.95 |