- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,510.61 / $1,596.64 / $8,229.00
| Facility | | $1,510.61 | $1,596.64 | $8,229.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,049.25 / $9,122.94 / $15,243.15
| Facility | | $5,049.25 | $9,122.94 | $15,243.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.52 / $2,032.09 / $2,344.16
| Facility | | $1,480.52 | $2,032.09 | $2,344.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,784.51 / $1,784.51 / $1,784.51
| Facility | | $1,784.51 | $1,784.51 | $1,784.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $175.15 / $175.15 / $175.15
| Facility | AS | $175.15 | $175.15 | $175.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $405.00 / $2,513.00 / $27,879.00
| Facility | | $405.00 | $2,513.00 | $27,879.00 |