- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,477.27 / $19,276.96
| Facility | | $4,083.97 | $8,477.27 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,701.61 / $6,701.61 / $6,701.61
| Facility | | $6,701.61 | $6,701.61 | $6,701.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $615.58 / $1,077.27 / $9,496.00
| Facility | | $615.58 | $1,077.27 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $174.07 / $2,401.96 / $2,401.96
| Facility | AS | $174.07 | $2,401.96 | $2,401.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,584.73 / $8,621.40
| Facility | | $1,089.00 | $1,584.73 | $8,621.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |