- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,020.22 / $5,597.00 / $11,627.00
| Facility | | $1,020.22 | $5,597.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,712.00 / $3,528.00 / $14,996.00
| Facility | | $1,712.00 | $3,528.00 | $14,996.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $626.17 / $803.64 / $1,067.33
| Facility | | $626.17 | $803.64 | $1,067.33 |
- 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
- $806.35 / $806.35 / $806.35
| Facility | | $806.35 | $806.35 | $806.35 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $78.93 / $78.93 / $78.93
| Facility | AS | $78.93 | $78.93 | $78.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,233.00 / $4,223.00 / $6,522.00
| Facility | | $2,233.00 | $4,223.00 | $6,522.00 |