- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,225.86 / $4,562.00 / $11,627.00
| Facility | | $1,225.86 | $4,562.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,777.00 / $6,565.00 / $30,285.00
| Facility | | $2,777.00 | $6,565.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.89 / $848.20 / $1,126.52
| Facility | | $660.89 | $848.20 | $1,126.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $755.26 / $1,444.39 / $5,051.50
| Facility | | $755.26 | $1,444.39 | $5,051.50 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $83.96 / $83.96 / $83.96
| Facility | AS | $83.96 | $83.96 | $83.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,231.00 / $10,075.00
| Facility | | $3,206.00 | $6,231.00 | $10,075.00 |