- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,294.51 / $3,104.00 / $7,283.00
| Facility | | $1,294.51 | $3,104.00 | $7,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,787.48 / $4,140.09
| Facility | | $672.35 | $2,787.48 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $637.69 / $855.16 / $7,167.00
| Facility | | $637.69 | $855.16 | $7,167.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.49 / $171.49 / $1,887.52
| Facility | AS | $171.49 | $171.49 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,637.00 / $6,477.00 / $9,010.00
| Facility | | $4,637.00 | $6,477.00 | $9,010.00 |