- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,083.97 / $8,355.33 / $19,276.96
| Facility | | $4,083.97 | $8,355.33 | $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
- $6,641.64 / $6,641.64 / $6,641.64
| Facility | | $6,641.64 | $6,641.64 | $6,641.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.48 / $1,007.09 / $9,496.00
| Facility | | $575.48 | $1,007.09 | $9,496.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $162.91 / $2,380.48 / $2,380.48
| Facility | AS | $162.91 | $2,380.48 | $2,380.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,089.00 / $1,533.67 / $8,412.74
| Facility | | $1,089.00 | $1,533.67 | $8,412.74 |
- 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 |