- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $864.20 / $9,062.00 / $18,276.00
| Facility | | $864.20 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,294.50 / $7,206.40 / $11,947.84
| Facility | | $3,294.50 | $7,206.40 | $11,947.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $855.93 / $5,740.31
| Facility | | $715.00 | $855.93 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.08 / $85.08 / $85.08
| Facility | AS | $85.08 | $85.08 | $85.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $826.49 / $1,029.67 / $1,648.69
| Facility | | $826.49 | $1,029.67 | $1,648.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.68 / $151.47 / $220.53
| Facility | AS | $125.68 | $151.47 | $220.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,456.00 / $19,591.00
| Facility | | $2,155.00 | $12,456.00 | $19,591.00 |