- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $654.67 / $2,678.00 / $7,602.00
| Facility | | $654.67 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $101.00 / $139.00 / $388.00
| Facility | | $101.00 | $139.00 | $388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $1,880.10 / $2,082.75
| Facility | | $55.00 | $1,880.10 | $2,082.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $97.54 / $188.01 / $188.01
| Facility | AS | $97.54 | $188.01 | $188.01 |
- 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 |