- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $6,329.00
| Facility | | $1,671.00 | $3,617.00 | $6,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.54 / $4,934.39 / $8,070.83
| Facility | | $1,341.54 | $4,934.39 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.42 / $1,586.99 / $10,106.46
| Facility | | $1,025.42 | $1,586.99 | $10,106.46 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $239.97 / $239.97 / $1,314.53
| Facility | AS | $239.97 | $239.97 | $1,314.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |