- 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
- $882.30 / $3,300.84 / $5,432.89
| Facility | | $882.30 | $3,300.84 | $5,432.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $158.81 / $241.93 / $4,172.00
| Facility | | $158.81 | $241.93 | $4,172.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $37.13 / $69.48 / $69.48
| Facility | AS | $37.13 | $69.48 | $69.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $14,572.00
| Facility | | $1,424.00 | $3,269.00 | $14,572.00 |