- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $7,943.28 / $14,454.40
| Facility | | $5,011.87 | $7,943.28 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,943.28 / $10,232.93 / $19,952.62
| Facility | | $7,943.28 | $10,232.93 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $691.83 / $1,258.93 / $10,471.29
| Facility | | $691.83 | $1,258.93 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.98 / $1,905.46 / $1,905.46
| Facility | AS | $194.98 | $1,905.46 | $1,905.46 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,479.11 / $1,737.80 / $2,398.83
| Professional | | $1,479.11 | $1,737.80 | $2,398.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $5,495.41 / $5,495.41
| Facility | | $5,495.41 | $5,495.41 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,786.30 / $7,413.10 / $9,549.93
| Facility | | $4,786.30 | $7,413.10 | $9,549.93 |