- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,582.00 / $2,897.00 / $6,483.00
| Facility | | $1,582.00 | $2,897.00 | $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
- $927.70 / $1,249.82 / $7,167.00
| Facility | | $927.70 | $1,249.82 | $7,167.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $251.53 / $251.53 / $1,661.06
| Facility | AS | $251.53 | $251.53 | $1,661.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,358.00 / $6,506.00 / $9,010.00
| Facility | | $4,358.00 | $6,506.00 | $9,010.00 |