- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.00 / $2,678.00 / $7,602.00
| Facility | | $1,821.00 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,428.00 / $2,387.00 / $4,372.00
| Facility | | $1,428.00 | $2,387.00 | $4,372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $10,960.02 / $11,281.77
| Facility | | $55.00 | $10,960.02 | $11,281.77 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $264.05 / $509.71 / $509.71
| Facility | AS | $264.05 | $509.71 | $509.71 |
- 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 |