- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.01 / $9,062.00 / $18,276.00
| Facility | | $1,141.01 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,271.03 / $7,056.09 / $12,933.02
| Facility | | $3,271.03 | $7,056.09 | $12,933.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $516.38 / $872.05 / $1,849.24
| Facility | | $516.38 | $872.05 | $1,849.24 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $76.34 / $89.74 / $214.14
| Facility | AS | $76.34 | $89.74 | $214.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,155.00 / $12,798.00 / $19,665.00
| Facility | | $2,155.00 | $12,798.00 | $19,665.00 |