- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $57,795.49
| Facility | | $1,671.00 | $4,474.00 | $57,795.49 |
- 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
- $1,778.00 / $3,251.23 / $6,074.17
| Facility | | $1,778.00 | $3,251.23 | $6,074.17 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $672.80 / $672.80 / $1,251.32
| Facility | AS | $672.80 | $672.80 | $1,251.32 |
- 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 |