- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $918.00 / $2,747.00 / $8,017.00
| Facility | | $918.00 | $2,747.00 | $8,017.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,639.91 / $25,716.00 / $39,341.64
| Facility | | $8,639.91 | $25,716.00 | $39,341.64 |
- 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
- $934.00 / $3,077.00 / $8,017.00
| Facility | | $934.00 | $3,077.00 | $8,017.00 |
- 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
- $625.97 / $625.97 / $844.98
| Facility | | $625.97 | $625.97 | $844.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,332.00 / $3,879.00 / $7,508.00
| Facility | | $2,332.00 | $3,879.00 | $7,508.00 |