- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,954.48 / $4,069.00 / $7,602.00
| Facility | | $1,954.48 | $4,069.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $2,387.00 / $4,827.00
| Facility | | $1,375.00 | $2,387.00 | $4,827.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $29,813.52 / $30,515.88
| Facility | | $55.00 | $29,813.52 | $30,515.88 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $528.57 / $1,067.11 / $1,067.11
| Facility | AS | $528.57 | $1,067.11 | $1,067.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,512.00 / $4,626.00
| Facility | | $1,233.00 | $2,512.00 | $4,626.00 |