- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,053.25 / $5,663.00 / $12,600.00
| Facility | | $1,053.25 | $5,663.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,997.28 / $12,508.22 / $19,618.43
| Facility | | $7,997.28 | $12,508.22 | $19,618.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,363.15 / $7,363.15 / $7,363.15
| Facility | | $7,363.15 | $7,363.15 | $7,363.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $601.32 / $860.40 / $14,063.00
| Facility | | $601.32 | $860.40 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $148.13 / $2,455.55 / $2,455.55
| Facility | AS | $148.13 | $2,455.55 | $2,455.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $6,980.00 / $14,139.00
| Facility | | $1,851.00 | $6,980.00 | $14,139.00 |