- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,404.39 / $7,831.95 / $16,467.00
| Facility | | $2,404.39 | $7,831.95 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,697.64 / $14,249.20 / $25,744.16
| Facility | | $5,697.64 | $14,249.20 | $25,744.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $890.00 / $7,694.64
| Facility | | $580.00 | $890.00 | $7,694.64 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $102.45 / $102.45 / $102.45
| Facility | AS | $102.45 | $102.45 | $102.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $983.41 / $1,166.00 / $1,979.65
| Facility | | $983.41 | $1,166.00 | $1,979.65 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $149.80 / $165.06 / $263.81
| Facility | AS | $149.80 | $165.06 | $263.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |