- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $4,745.00 / $9,429.00
| Facility | | $2,073.00 | $4,745.00 | $9,429.00 |
- 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
- $1,151.18 / $1,600.20 / $4,337.00
| Facility | | $1,151.18 | $1,600.20 | $4,337.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $306.69 / $545.58 / $545.58
| Facility | AS | $306.69 | $545.58 | $545.58 |
- 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 |