- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,070.39 / $7,501.00 / $16,305.00
| Facility | | $1,070.39 | $7,501.00 | $16,305.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,443.00 / $29,300.94 / $53,822.78
| Facility | | $2,443.00 | $29,300.94 | $53,822.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.14 / $720.16 / $1,048.65
| Facility | | $660.14 | $720.16 | $1,048.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $840.68 / $840.68 / $27,795.60
| Facility | | $840.68 | $840.68 | $27,795.60 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.44 / $83.44 / $83.44
| Facility | AS | $83.44 | $83.44 | $83.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,227.00 / $9,067.00 / $14,134.00
| Facility | | $4,227.00 | $9,067.00 | $14,134.00 |