- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $7,562.14
| Facility | | $1,671.00 | $3,617.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,805.25 / $6,640.00 / $10,860.55
| Facility | | $1,805.25 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,131.24 / $1,720.78 / $4,466.00
| Facility | | $1,131.24 | $1,720.78 | $4,466.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $264.05 / $264.05 / $495.17
| Facility | AS | $264.05 | $264.05 | $495.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $6,416.00
| Facility | | $1,424.00 | $3,269.00 | $6,416.00 |