- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $3,058.40 / $7,439.00
| Facility | | $1,615.00 | $3,058.40 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,016.00 / $3,747.30 / $6,104.10
| Facility | | $2,016.00 | $3,747.30 | $6,104.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $282.24 / $481.12 / $985.15
| Facility | AS | $282.24 | $481.12 | $985.15 |
- 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 / $58,842.42 / $71,015.28
| Facility | | $55.00 | $58,842.42 | $71,015.28 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $675.57 / $738.01 / $1,426.32
| Facility | AS | $675.57 | $738.01 | $1,426.32 |