- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,311.00 / $4,224.70 / $10,234.00
| Facility | | $2,311.00 | $4,224.70 | $10,234.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $2,302.00 / $4,372.00
| Facility | | $1,275.00 | $2,302.00 | $4,372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $46,078.80 / $47,192.77
| Facility | | $55.00 | $46,078.80 | $47,192.77 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $528.72 / $1,025.43 / $1,025.43
| Facility | AS | $528.72 | $1,025.43 | $1,025.43 |
- 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 |