- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.00 / $3,617.00 / $7,467.00
| Facility | | $1,070.00 | $3,617.00 | $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
- $541.73 / $734.76 / $3,311.00
| Facility | | $541.73 | $734.76 | $3,311.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $247.81 / $247.81 / $247.81
| Facility | AS | $247.81 | $247.81 | $247.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |