- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.00 / $5,463.36 / $13,841.56
| Facility | | $1,653.00 | $5,463.36 | $13,841.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,828.40 / $10,296.48 / $19,916.72
| Facility | | $7,828.40 | $10,296.48 | $19,916.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $16,316.30 / $16,316.30 / $16,316.30
| Facility | | $16,316.30 | $16,316.30 | $16,316.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $403.67 / $726.61 / $9,696.00
| Facility | | $403.67 | $726.61 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.50 / $5,848.03 / $5,848.03
| Facility | AS | $112.50 | $5,848.03 | $5,848.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.14 / $1,082.45 / $20,667.31
| Facility | | $815.14 | $1,082.45 | $20,667.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |