- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.39 / $3,635.45 / $10,032.00
| Facility | | $1,851.39 | $3,635.45 | $10,032.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,143.48 / $5,350.19 / $9,222.64
| Facility | | $2,143.48 | $5,350.19 | $9,222.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $792.20 / $1,965.14 / $2,345.00
| Facility | | $792.20 | $1,965.14 | $2,345.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $78.67 / $78.67 / $78.67
| Facility | AS | $78.67 | $78.67 | $78.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $764.51 / $876.43 / $1,528.19
| Facility | | $764.51 | $876.43 | $1,528.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $120.02 / $120.02 / $202.43
| Facility | AS | $120.02 | $120.02 | $202.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,550.00 / $10,257.00 / $16,249.00
| Facility | | $1,550.00 | $10,257.00 | $16,249.00 |