- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,048.00 / $3,821.00 / $12,600.00
| Facility | | $1,048.00 | $3,821.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $26,543.64 / $41,378.87 / $64,521.82
| Facility | | $26,543.64 | $41,378.87 | $64,521.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $870.65 / $1,534.83 / $24,973.38
| Facility | | $870.65 | $1,534.83 | $24,973.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $9,288.33 / $9,288.33 / $9,288.33
| Facility | AS | $9,288.33 | $9,288.33 | $9,288.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,412.00 / $14,790.00 / $31,828.64
| Facility | | $3,412.00 | $14,790.00 | $31,828.64 |