- 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
- $1,805.25 / $6,640.00 / $10,860.55
| Facility | | $1,805.25 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.87 / $2,312.00 / $4,466.00
| Facility | | $1,712.87 | $2,312.00 | $4,466.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $443.31 / $443.31 / $824.12
| Facility | AS | $443.31 | $443.31 | $824.12 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $6,416.00
| Facility | | $1,424.00 | $3,269.00 | $6,416.00 |