- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $929.38 / $3,278.00 / $10,635.00
| Facility | | $929.38 | $3,278.00 | $10,635.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,443.00 / $16,268.05 / $29,882.70
| Facility | | $2,443.00 | $16,268.05 | $29,882.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $572.80 / $735.17 / $976.40
| Facility | | $572.80 | $735.17 | $976.40 |
- 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
- $733.18 / $733.18 / $733.18
| Facility | | $733.18 | $733.18 | $733.18 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $72.81 / $72.81 / $72.81
| Facility | AS | $72.81 | $72.81 | $72.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,231.00 / $10,075.00
| Facility | | $3,206.00 | $6,231.00 | $10,075.00 |