- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $631.12 / $631.12 / $8,080.50
| Facility | | $631.12 | $631.12 | $8,080.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,800.34 / $12,197.67 / $25,424.06
| Facility | | $2,800.34 | $12,197.67 | $25,424.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,530.45 / $2,171.48 / $5,223.80
| Facility | | $1,530.45 | $2,171.48 | $5,223.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $70.80 / $70.80 / $70.80
| Facility | AS | $70.80 | $70.80 | $70.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,391.32 / $1,985.26 / $4,113.22
| Facility | | $1,391.32 | $1,985.26 | $4,113.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $634.63 / $1,093.55 / $3,991.00
| Facility | | $634.63 | $1,093.55 | $3,991.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $160.83 / $160.83 / $160.83
| Facility | AS | $160.83 | $160.83 | $160.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,121.00 / $9,404.00 / $23,633.78
| Facility | | $3,121.00 | $9,404.00 | $23,633.78 |