- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,311.00 / $5,008.67 / $8,199.45
| Facility | | $2,311.00 | $5,008.67 | $8,199.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $2,326.00 / $4,528.00
| Facility | | $1,275.00 | $2,326.00 | $4,528.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $72,435.30 / $74,272.38
| Facility | | $55.00 | $72,435.30 | $74,272.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $750.85 / $1,451.38 / $1,451.38
| Facility | AS | $750.85 | $1,451.38 | $1,451.38 |
- 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 |