- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,912.00 / $6,483.00
| Facility | | $1,582.00 | $2,912.00 | $6,483.00 |
- 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
- $547.42 / $753.78 / $3,790.00
| Facility | | $547.42 | $753.78 | $3,790.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $152.13 / $152.13 / $497.27
| Facility | AS | $152.13 | $152.13 | $497.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,343.00 / $3,339.00 / $5,838.00
| Facility | | $2,343.00 | $3,339.00 | $5,838.00 |