- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,538.24 / $9,544.15 / $20,928.72
| Facility | | $1,538.24 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,183.05 / $10,762.95 / $20,819.02
| Facility | | $8,183.05 | $10,762.95 | $20,819.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,479.92 / $13,479.92 / $13,479.92
| Facility | | $13,479.92 | $13,479.92 | $13,479.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,209.96 / $2,238.42 / $9,696.00
| Facility | | $1,209.96 | $2,238.42 | $9,696.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $337.62 / $4,831.43 / $4,831.43
| Facility | AS | $337.62 | $4,831.43 | $4,831.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,525.44 / $3,020.77 / $17,074.56
| Facility | | $1,525.44 | $3,020.77 | $17,074.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |