- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,032.08 / $5,136.32 / $11,627.00
| Facility | | $1,032.08 | $5,136.32 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,528.00 / $14,996.00
| Facility | | $1,712.00 | $3,528.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $634.57 / $814.42 / $1,081.65
| Facility | | $634.57 | $814.42 | $1,081.65 |
- 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
- $812.42 / $812.42 / $812.42
| Facility | | $812.42 | $812.42 | $812.42 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $80.87 / $80.87 / $80.87
| Facility | AS | $80.87 | $80.87 | $80.87 |
- 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 |