- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,303.68 / $6,975.78 / $13,493.42
| Facility | | $5,303.68 | $6,975.78 | $13,493.42 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,630.03 / $12,630.03 / $12,630.03
| Facility | | $12,630.03 | $12,630.03 | $12,630.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $884.89 / $1,778.08 / $8,816.00
| Facility | | $884.89 | $1,778.08 | $8,816.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $290.61 / $4,526.82 / $4,526.82
| Facility | AS | $290.61 | $4,526.82 | $4,526.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,306.83 / $2,553.89 / $15,998.04
| Facility | | $1,306.83 | $2,553.89 | $15,998.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,341.00 / $7,441.00 / $8,816.00
| Facility | | $5,341.00 | $7,441.00 | $8,816.00 |