- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,227.77 / $3,788.64 / $7,602.00
| Facility | | $1,227.77 | $3,788.64 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $2,324.00 / $4,372.00
| Facility | | $1,275.00 | $2,324.00 | $4,372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $55,133.40 / $56,499.45
| Facility | | $55.00 | $55,133.40 | $56,499.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $572.25 / $1,109.65 / $1,109.65
| Facility | AS | $572.25 | $1,109.65 | $1,109.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,665.00 / $4,918.00
| Facility | | $1,233.00 | $2,665.00 | $4,918.00 |