- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,268.04 / $9,809.31 / $25,400.43
| Facility | | $2,268.04 | $9,809.31 | $25,400.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,501.00 / $13,621.30 / $25,522.00
| Facility | | $3,501.00 | $13,621.30 | $25,522.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,656.63 / $1,987.96 / $2,460.53
| Facility | | $1,656.63 | $1,987.96 | $2,460.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $1,200.00 / $21,571.00
| Facility | | $425.00 | $1,200.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.20 / $194.20 / $194.20
| Facility | AS | $194.20 | $194.20 | $194.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $425.00 / $1,980.11 / $18,603.77
| Facility | | $425.00 | $1,980.11 | $18,603.77 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.20 / $194.20 / $194.20
| Facility | AS | $194.20 | $194.20 | $194.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $6,811.00 / $13,009.00
| Facility | | $1,275.00 | $6,811.00 | $13,009.00 |