- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,314.00 / $3,617.00 / $7,467.00
| Facility | | $1,314.00 | $3,617.00 | $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
- $1,075.09 / $1,443.85 / $9,251.00
| Facility | | $1,075.09 | $1,443.85 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $286.66 / $286.66 / $4,708.97
| Facility | AS | $286.66 | $286.66 | $4,708.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,279.00 / $7,341.00 / $11,396.00
| Facility | | $5,279.00 | $7,341.00 | $11,396.00 |