- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,260.00 / $6,301.00 / $11,390.00
| Facility | | $2,260.00 | $6,301.00 | $11,390.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,310.70 / $5,094.77 / $8,070.83
| Facility | | $1,310.70 | $5,094.77 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,423.31 / $1,978.54 / $9,437.00
| Facility | | $1,423.31 | $1,978.54 | $9,437.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.43 / $2,105.03 / $2,105.03
| Facility | AS | $380.43 | $2,105.03 | $2,105.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,364.00 / $8,241.00 / $11,396.00
| Facility | | $5,364.00 | $8,241.00 | $11,396.00 |