- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $4,474.00 / $98,642.60
| Facility | | $1,671.00 | $4,474.00 | $98,642.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,763.75 / $6,598.50 / $10,860.55
| Facility | | $1,763.75 | $6,598.50 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,742.75 / $2,173.00 / $4,425.97
| Facility | | $1,742.75 | $2,173.00 | $4,425.97 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $475.90 / $919.95 / $919.95
| Facility | AS | $475.90 | $919.95 | $919.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $14,572.00
| Facility | | $1,424.00 | $3,269.00 | $14,572.00 |