- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,119.50 / $8,447.00
| Facility | | $1,671.00 | $4,119.50 | $8,447.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $781.60 / $2,918.30 / $5,113.62
| Facility | | $781.60 | $2,918.30 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.00 / $3,216.04 / $5,269.46
| Facility | | $630.00 | $3,216.04 | $5,269.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $356.01 / $443.02 / $6,014.00
| Facility | | $356.01 | $443.02 | $6,014.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $93.56 / $1,537.78 / $1,537.78
| Facility | AS | $93.56 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,350.00 / $6,230.00 / $9,010.00
| Facility | | $2,350.00 | $6,230.00 | $9,010.00 |