- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,369.38 / $2,698.28 / $16,467.00
| Facility | | $1,369.38 | $2,698.28 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,119.24 / $10,717.58 / $18,474.93
| Facility | | $4,119.24 | $10,717.58 | $18,474.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.20 / $1,543.02 / $2,345.15
| Facility | | $1,044.20 | $1,543.02 | $2,345.15 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $174.72 / $228.90 / $264.10
| Facility | AS | $174.72 | $228.90 | $264.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,627.00 / $25,620.00
| Facility | | $3,028.00 | $19,627.00 | $25,620.00 |