- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,437.00 / $6,329.00
| Facility | | $1,671.00 | $3,437.00 | $6,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,598.50 / $10,860.55
| Facility | | $1,763.75 | $6,598.50 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,508.70 / $2,171.19 / $15,169.00
| Facility | | $1,508.70 | $2,171.19 | $15,169.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $401.65 / $746.31 / $746.31
| Facility | AS | $401.65 | $746.31 | $746.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,560.00 / $10,316.00 / $16,841.00
| Facility | | $3,560.00 | $10,316.00 | $16,841.00 |