- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,544.19 / $8,388.96 / $20,928.72
| Facility | | $3,544.19 | $8,388.96 | $20,928.72 |
- 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
- $7,139.18 / $7,139.18 / $7,139.18
| Facility | | $7,139.18 | $7,139.18 | $7,139.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $679.92 / $1,223.85 / $8,892.70
| Facility | | $679.92 | $1,223.85 | $8,892.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $192.60 / $2,558.80 / $2,558.80
| Facility | AS | $192.60 | $2,558.80 | $2,558.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,269.00 / $1,707.62 / $9,042.95
| Facility | | $1,269.00 | $1,707.62 | $9,042.95 |
- 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 |