- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,461.06 / $2,403.83 / $7,439.00
| Facility | | $1,461.06 | $2,403.83 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,760.00 / $2,403.83 / $4,815.72
| Facility | | $1,760.00 | $2,403.83 | $4,815.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $246.40 / $263.11 / $792.64
| Facility | AS | $246.40 | $263.11 | $792.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,172.00 / $4,086.00 / $7,778.00
| Facility | | $1,172.00 | $4,086.00 | $7,778.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $47,443.83 / $57,191.82
| Facility | | $55.00 | $47,443.83 | $57,191.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $541.53 / $593.40 / $1,150.58
| Facility | AS | $541.53 | $593.40 | $1,150.58 |