- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $6,329.00
| Facility | | $1,671.00 | $3,617.00 | $6,329.00 |
- 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
- $1,788.23 / $2,347.21 / $4,466.00
| Facility | | $1,788.23 | $2,347.21 | $4,466.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $528.57 / $1,020.61 / $1,020.61
| Facility | AS | $528.57 | $1,020.61 | $1,020.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,360.00 / $2,572.00 / $6,416.00
| Facility | | $1,360.00 | $2,572.00 | $6,416.00 |