- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $651.86 / $9,062.00 / $18,276.00
| Facility | | $651.86 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,911.85 / $7,206.40 / $12,212.57
| Facility | | $2,911.85 | $7,206.40 | $12,212.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.60 / $715.00 / $2,581.96
| Facility | | $650.60 | $715.00 | $2,581.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $64.56 / $64.56 / $64.56
| Facility | AS | $64.56 | $64.56 | $64.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $644.92 / $821.00 / $1,236.96
| Facility | | $644.92 | $821.00 | $1,236.96 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $91.30 / $143.24 / $180.97
| Facility | AS | $91.30 | $143.24 | $180.97 |
- 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 |