- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $10,431.19 / $20,928.72
| Facility | | $4,241.22 | $10,431.19 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,859.66 / $2,445.96 / $4,731.27
| Facility | | $1,859.66 | $2,445.96 | $4,731.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $650.22 / $968.96 / $4,406.00
| Facility | | $650.22 | $968.96 | $4,406.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $262.80 / $262.80 / $262.80
| Facility | AS | $262.80 | $262.80 | $262.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,025.80 / $1,263.47 / $1,704.06
| Facility | | $1,025.80 | $1,263.47 | $1,704.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |