- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,392.00 / $5,511.00 / $16,900.00
| Facility | | $1,392.00 | $5,511.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,380.40 / $11,665.17 / $18,573.80
| Facility | | $7,380.40 | $11,665.17 | $18,573.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $979.84 / $1,379.43 / $6,710.71
| Facility | | $979.84 | $1,379.43 | $6,710.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $439.01 / $439.01 / $439.01
| Facility | AS | $439.01 | $439.01 | $439.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,091.00 / $4,054.00 / $7,077.94
| Facility | | $1,091.00 | $4,054.00 | $7,077.94 |