- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,819.00 / $8,104.00
| Facility | | $1,671.00 | $3,819.00 | $8,104.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,598.50 / $10,860.55
| Facility | | $1,763.75 | $6,598.50 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,264.99 / $1,745.82 / $4,337.00
| Facility | | $1,264.99 | $1,745.82 | $4,337.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $340.11 / $603.26 / $603.26
| Facility | AS | $340.11 | $603.26 | $603.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $14,572.00
| Facility | | $1,424.00 | $3,269.00 | $14,572.00 |