- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,095.00 / $5,907.48 / $7,838.38
| Facility | | $2,095.00 | $5,907.48 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.25 / $10,791.27 / $17,368.09
| Facility | | $2,343.25 | $10,791.27 | $17,368.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $670.45 / $670.45 / $1,996.40
| Facility | | $670.45 | $670.45 | $1,996.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $66.25 / $66.25 / $66.25
| Facility | AS | $66.25 | $66.25 | $66.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $571.70 / $743.35 / $998.30
| Facility | | $571.70 | $743.35 | $998.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $66.25 / $66.25 / $66.25
| Facility | AS | $66.25 | $66.25 | $66.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $9,127.00 / $10,150.00
| Facility | | $1,230.00 | $9,127.00 | $10,150.00 |