- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.34 / $9,062.00 / $17,247.00
| Facility | | $1,058.34 | $9,062.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,345.04 / $7,618.81 / $14,553.54
| Facility | | $3,345.04 | $7,618.81 | $14,553.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $901.89 / $1,164.19 / $2,082.75
| Facility | | $901.89 | $1,164.19 | $2,082.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $150.08 / $155.97 / $261.39
| Facility | AS | $150.08 | $155.97 | $261.39 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |