- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $8,477.27 / $20,928.72
| Facility | | $4,241.22 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,823.60 / $13,313.50 / $24,992.84
| Facility | | $9,823.60 | $13,313.50 | $24,992.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,298.33 / $2,251.29 / $7,856.00
| Facility | | $1,298.33 | $2,251.29 | $7,856.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $603.26 / $603.26 / $603.26
| Facility | AS | $603.26 | $603.26 | $603.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,333.00 / $3,039.97 / $4,080.38
| Facility | | $2,333.00 | $3,039.97 | $4,080.38 |
- 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 |