- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,099.50 / $11,025.00 / $17,260.93
| Facility | | $1,099.50 | $11,025.00 | $17,260.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,783.09 / $10,824.58 / $17,240.66
| Facility | | $4,783.09 | $10,824.58 | $17,240.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $1,082.47
| Facility | | $890.00 | $890.00 | $1,082.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $106.37 / $106.37 / $106.37
| Facility | AS | $106.37 | $106.37 | $106.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,064.88 / $1,336.05 / $2,120.71
| Facility | | $1,064.88 | $1,336.05 | $2,120.71 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $162.75 / $193.76 / $281.38
| Facility | AS | $162.75 | $193.76 | $281.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |