- 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
- $882.30 / $3,300.84 / $5,432.89
| Facility | | $882.30 | $3,300.84 | $5,432.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $196.13 / $300.74 / $3,790.00
| Facility | | $196.13 | $300.74 | $3,790.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $50.90 / $102.75 / $102.75
| Facility | AS | $50.90 | $102.75 | $102.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $14,572.00
| Facility | | $1,424.00 | $3,269.00 | $14,572.00 |