- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.42 / $3,477.00 / $7,467.00
| Facility | | $1,202.42 | $3,477.00 | $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
- $592.33 / $791.68 / $6,063.00
| Facility | | $592.33 | $791.68 | $6,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $157.71 / $157.71 / $849.00
| Facility | AS | $157.71 | $157.71 | $849.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,021.00 / $4,545.00 / $7,217.00
| Facility | | $3,021.00 | $4,545.00 | $7,217.00 |