- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,400.00 / $3,776.94 / $51,307.98
| Facility | | $1,400.00 | $3,776.94 | $51,307.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.34 / $727.38 / $792.49
| Facility | | $652.34 | $727.38 | $792.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $703.10 / $703.10 / $703.10
| Facility | | $703.10 | $703.10 | $703.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $69.31 / $69.31 / $69.31
| Facility | AS | $69.31 | $69.31 | $69.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,224.46 / $10,176.01 / $20,995.00
| Facility | | $4,224.46 | $10,176.01 | $20,995.00 |