- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,114.00 / $4,474.00 / $7,960.15
| Facility | | $2,114.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,351.11 / $5,179.08
| Facility | | $830.45 | $3,351.11 | $5,179.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,267.88 / $1,703.52 / $9,251.00
| Facility | | $1,267.88 | $1,703.52 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $337.62 / $337.62 / $4,831.43
| Facility | AS | $337.62 | $337.62 | $4,831.43 |
- 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 |