- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,445.50 / $3,477.00 / $7,467.00
| Facility | | $1,445.50 | $3,477.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,515.38 / $4,140.09
| Facility | | $672.35 | $2,515.38 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $387.78 / $584.78 / $7,168.00
| Facility | | $387.78 | $584.78 | $7,168.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $91.00 / $1,279.44 / $1,279.44
| Facility | AS | $91.00 | $1,279.44 | $1,279.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,094.00 / $6,455.00 / $9,010.00
| Facility | | $4,094.00 | $6,455.00 | $9,010.00 |