- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,615.00 / $2,731.65 / $7,439.00
| Facility | | $1,615.00 | $2,731.65 | $7,439.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,561.17 / $3,531.85 / $6,034.69
| Facility | | $2,561.17 | $3,531.85 | $6,034.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.66 / $494.46 / $844.86
| Facility | AS | $380.66 | $494.46 | $844.86 |
- 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 / $45,723.69 / $55,131.73
| Facility | | $55.00 | $45,723.69 | $55,131.73 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $578.15 / $632.47 / $1,224.71
| Facility | AS | $578.15 | $632.47 | $1,224.71 |