- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $7,960.15
| Facility | | $1,671.00 | $3,617.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,734.49 / $4,193.09
| Facility | | $672.35 | $2,734.49 | $4,193.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $518.60 / $704.52 / $9,251.00
| Facility | | $518.60 | $704.52 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.38 / $138.38 / $1,887.52
| Facility | AS | $138.38 | $138.38 | $1,887.52 |
- 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 |