- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $940.35 / $9,062.00 / $18,276.00
| Facility | | $940.35 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,835.02 / $10,249.16 / $18,314.23
| Facility | | $4,835.02 | $10,249.16 | $18,314.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $815.00 / $932.57 / $5,740.31
| Facility | | $815.00 | $932.57 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $92.68 / $92.68 / $92.68
| Facility | AS | $92.68 | $92.68 | $92.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $904.45 / $1,175.43 / $1,802.71
| Facility | | $904.45 | $1,175.43 | $1,802.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.25 / $180.88 / $241.04
| Facility | AS | $138.25 | $180.88 | $241.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |