- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $7,960.15
| Facility | | $1,671.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,660.00 / $6,198.03 / $10,860.55
| Facility | | $1,660.00 | $6,198.03 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,532.07 / $2,138.31 / $4,349.00
| Facility | | $1,532.07 | $2,138.31 | $4,349.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $498.58 / $927.06 / $927.06
| Facility | AS | $498.58 | $927.06 | $927.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $175.00 / $2,572.00 / $14,572.00
| Facility | | $175.00 | $2,572.00 | $14,572.00 |