- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,312.69 / $4,286.94 / $10,064.47
| Facility | | $1,312.69 | $4,286.94 | $10,064.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,749.00 / $9,877.00 / $17,400.00
| Facility | | $4,749.00 | $9,877.00 | $17,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,126.75 / $3,632.03 / $5,441.47
| Facility | | $1,126.75 | $3,632.03 | $5,441.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $111.77 / $111.77 / $111.77
| Facility | AS | $111.77 | $111.77 | $111.77 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $7,457.00 / $14,139.00
| Facility | | $3,028.00 | $7,457.00 | $14,139.00 |