- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $2,630.27 / $6,606.93
| Facility | | $1,000.00 | $2,630.27 | $6,606.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,918.31 / $10,715.19 / $17,782.79
| Facility | | $6,918.31 | $10,715.19 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $1,380.38 / $6,165.95
| Facility | | $489.78 | $1,380.38 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $407.38 / $407.38 / $407.38
| Facility | AS | $407.38 | $407.38 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,949.84 / $6,165.95
| Facility | | $346.74 | $1,949.84 | $6,165.95 |