- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,758.00 / $8,407.00
| Facility | | $1,671.00 | $3,758.00 | $8,407.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $688.17 / $2,864.21 / $4,928.72
| Facility | | $688.17 | $2,864.21 | $4,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $934.40 / $1,269.38 / $9,799.00
| Facility | | $934.40 | $1,269.38 | $9,799.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $248.41 / $248.41 / $2,488.28
| Facility | AS | $248.41 | $248.41 | $2,488.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,707.00 / $8,317.00 / $11,396.00
| Facility | | $5,707.00 | $8,317.00 | $11,396.00 |