- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,083.18 / $5,889.14 / $11,679.00
| Facility | | $1,083.18 | $5,889.14 | $11,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $6,003.00 / $30,285.00
| Facility | | $2,670.00 | $6,003.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $583.53 / $748.91 / $994.65
| Facility | | $583.53 | $748.91 | $994.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $749.18 / $749.18 / $1,993.00
| Facility | | $749.18 | $749.18 | $1,993.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $74.45 / $74.45 / $74.45
| Facility | AS | $74.45 | $74.45 | $74.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |