- 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
- $1,090.70 / $1,502.51 / $4,545.00
| Facility | | $1,090.70 | $1,502.51 | $4,545.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $335.18 / $621.27 / $621.27
| Facility | AS | $335.18 | $621.27 | $621.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $4,352.00 / $7,217.00
| Facility | | $1,424.00 | $4,352.00 | $7,217.00 |