- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $3,684.00 / $18,600.00
| Facility | | $1,346.00 | $3,684.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $20,922.43 / $30,321.65 / $42,212.83
| Facility | | $20,922.43 | $30,321.65 | $42,212.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $498.00 / $3,108.32 / $6,155.68
| Facility | | $498.00 | $3,108.32 | $6,155.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,092.52 / $1,092.52 / $1,092.52
| Facility | AS | $1,092.52 | $1,092.52 | $1,092.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.00 / $1,760.00 / $6,155.68
| Facility | | $350.00 | $1,760.00 | $6,155.68 |