- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,073.00 / $4,521.00 / $7,960.15
| Facility | | $2,073.00 | $4,521.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $587.35 / $2,211.19 / $3,616.69
| Facility | | $587.35 | $2,211.19 | $3,616.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,269.46 / $5,269.46 / $5,269.46
| Facility | | $5,269.46 | $5,269.46 | $5,269.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $682.01 / $920.08 / $9,251.00
| Facility | | $682.01 | $920.08 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $178.81 / $1,537.78 / $1,537.78
| Facility | AS | $178.81 | $1,537.78 | $1,537.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,315.00 / $7,341.00 / $11,396.00
| Facility | | $5,315.00 | $7,341.00 | $11,396.00 |