- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $619.08 / $9,544.15 / $20,928.72
| Facility | | $619.08 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,921.80 / $10,419.34 / $20,154.36
| Facility | | $7,921.80 | $10,419.34 | $20,154.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $619.08 / $1,114.33 / $8,892.70
| Facility | | $619.08 | $1,114.33 | $8,892.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $174.51 / $1,887.52 / $1,887.52
| Facility | AS | $174.51 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,250.40 / $1,553.89 / $6,616.19
| Facility | | $1,250.40 | $1,553.89 | $6,616.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |