- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,467.00
| Facility | | $1,671.00 | $4,474.00 | $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
- $586.53 / $790.08 / $6,063.00
| Facility | | $586.53 | $790.08 | $6,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $157.18 / $157.18 / $1,887.52
| Facility | AS | $157.18 | $157.18 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,892.00 / $4,545.00 / $7,217.00
| Facility | | $2,892.00 | $4,545.00 | $7,217.00 |