- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,165.00 / $5,201.00 / $11,627.00
| Facility | | $1,165.00 | $5,201.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,674.00 / $6,565.00 / $30,285.00
| Facility | | $2,674.00 | $6,565.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $727.64 / $793.79 / $1,155.86
| Facility | | $727.64 | $793.79 | $1,155.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $945.10 / $945.10 / $945.10
| Facility | | $945.10 | $945.10 | $945.10 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $94.51 / $94.51 / $94.51
| Facility | AS | $94.51 | $94.51 | $94.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,840.00 / $5,625.00 / $7,847.00
| Facility | | $2,840.00 | $5,625.00 | $7,847.00 |