- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $467.96 / $1,893.00 / $5,607.00
| Facility | | $467.96 | $1,893.00 | $5,607.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,516.71 / $7,761.49 / $11,123.74
| Facility | | $3,516.71 | $7,761.49 | $11,123.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $308.35 / $5,023.22 / $5,023.22
| Facility | | $308.35 | $5,023.22 | $5,023.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $375.23 / $731.00 / $3,963.12
| Facility | | $375.23 | $731.00 | $3,963.12 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $37.06 / $37.06 / $37.06
| Facility | AS | $37.06 | $37.06 | $37.06 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.00 / $4,717.00 / $10,959.00
| Facility | | $1,141.00 | $4,717.00 | $10,959.00 |