- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,704.00 / $5,389.00 / $13,151.00
| Facility | | $1,704.00 | $5,389.00 | $13,151.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,232.00 / $6,492.00 / $15,862.67
| Facility | | $2,232.00 | $6,492.00 | $15,862.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,454.69 / $2,356.14 / $9,475.00
| Facility | | $1,454.69 | $2,356.14 | $9,475.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.34 / $380.34 / $723.76
| Facility | AS | $380.34 | $380.34 | $723.76 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,578.00 / $6,058.00 / $19,082.00
| Facility | | $2,578.00 | $6,058.00 | $19,082.00 |