- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,447.00 / $7,960.15
| Facility | | $1,671.00 | $4,447.00 | $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
- $1,045.53 / $1,339.88 / $4,571.00
| Facility | | $1,045.53 | $1,339.88 | $4,571.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $285.02 / $513.03 / $513.03
| Facility | AS | $285.02 | $513.03 | $513.03 |
- 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 |