- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $795.02 / $8,477.27 / $20,928.72
| Facility | | $795.02 | $8,477.27 | $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
- $795.02 / $1,391.29 / $5,162.70
| Facility | | $795.02 | $1,391.29 | $5,162.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $220.18 / $407.22 / $407.22
| Facility | AS | $220.18 | $407.22 | $407.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,060.66 / $1,957.77 / $2,659.29
| Facility | | $1,060.66 | $1,957.77 | $2,659.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,158.00 / $9,696.00 / $15,622.00
| Facility | | $8,158.00 | $9,696.00 | $15,622.00 |