- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $3,467.37 / $11,481.54
| Facility | | $933.25 | $3,467.37 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $8,912.51 / $17,782.79
| Facility | | $4,365.16 | $8,912.51 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $8,709.64 / $8,709.64
| Facility | | $912.01 | $8,709.64 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $19,952.62 / $45,708.82 / $45,708.82
| Facility | | $19,952.62 | $45,708.82 | $45,708.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,995.26 / $1,995.26 / $1,995.26
| Facility | AS | $1,995.26 | $1,995.26 | $1,995.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,318.26 / $4,073.80
| Facility | | $912.01 | $1,318.26 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $1,230.27 / $2,089.30
| Facility | | $933.25 | $1,230.27 | $2,089.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.82 / $169.82 / $169.82
| Facility | AS | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,187.76 / $6,918.31 / $14,125.38
| Facility | | $2,187.76 | $6,918.31 | $14,125.38 |