- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $7,562.14
| Facility | | $1,671.00 | $3,617.00 | $7,562.14 |
- 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
- $1,276.84 / $1,770.00 / $4,349.00
| Facility | | $1,276.84 | $1,770.00 | $4,349.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $323.94 / $602.50 / $602.50
| Facility | AS | $323.94 | $602.50 | $602.50 |
- 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 |