- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.06 / $7,252.00 / $16,467.00
| Facility | | $755.06 | $7,252.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,829.27 / $10,337.65 / $17,744.71
| Facility | | $4,829.27 | $10,337.65 | $17,744.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $715.00 / $755.12 / $5,740.31
| Facility | | $715.00 | $755.12 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $74.86 / $74.86 / $74.86
| Facility | AS | $74.86 | $74.86 | $74.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $700.00 / $896.01 / $1,432.10
| Facility | | $700.00 | $896.01 | $1,432.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $107.61 / $128.38 / $190.46
| Facility | AS | $107.61 | $128.38 | $190.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |