- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,456.00 / $5,915.00 / $14,100.00
| Facility | | $1,456.00 | $5,915.00 | $14,100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,666.79 / $13,768.47 / $21,754.02
| Facility | | $8,666.79 | $13,768.47 | $21,754.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $24,466.28 / $24,466.28 / $24,466.28
| Facility | | $24,466.28 | $24,466.28 | $24,466.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $798.71 / $1,296.64 / $19,869.87
| Facility | | $798.71 | $1,296.64 | $19,869.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $203.97 / $8,159.30 / $8,159.30
| Facility | AS | $203.97 | $8,159.30 | $8,159.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.00 / $10,642.00 / $20,423.23
| Facility | | $3,228.00 | $10,642.00 | $20,423.23 |