- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.50 / $3,104.00 / $7,283.00
| Facility | | $1,445.50 | $3,104.00 | $7,283.00 |
- 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
- $727.93 / $1,039.61 / $9,251.00
| Facility | | $727.93 | $1,039.61 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $214.60 / $214.60 / $2,411.58
| Facility | AS | $214.60 | $214.60 | $2,411.58 |
- 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 |