- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,431.19 / $21,899.37
| Facility | | $5,463.36 | $10,431.19 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,992.68 / $9,476.87 / $17,790.50
| Facility | | $6,992.68 | $9,476.87 | $17,790.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $748.77 / $1,319.21 / $7,221.00
| Facility | | $748.77 | $1,319.21 | $7,221.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $347.57 / $347.57 / $347.57
| Facility | AS | $347.57 | $347.57 | $347.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,220.00 / $1,671.03 / $2,353.67
| Facility | | $1,220.00 | $1,671.03 | $2,353.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |