- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,597.73 / $7,439.00
| Facility | | $1,615.00 | $2,597.73 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,425.00 / $3,377.65 / $5,825.34
| Facility | | $2,425.00 | $3,377.65 | $5,825.34 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $339.50 / $397.53 / $815.55
| Facility | AS | $339.50 | $397.53 | $815.55 |
- 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 / $48,828.15 / $58,842.21
| Facility | | $55.00 | $48,828.15 | $58,842.21 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $557.32 / $610.29 / $1,183.24
| Facility | AS | $557.32 | $610.29 | $1,183.24 |