- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $898.13 / $1,711.04 / $13,268.53
| Facility | | $898.13 | $1,711.04 | $13,268.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,565.00 / $6,760.00 / $17,190.00
| Facility | | $3,565.00 | $6,760.00 | $17,190.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $922.53 / $1,257.24 / $1,450.33
| Facility | | $922.53 | $1,257.24 | $1,450.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,080.61 / $1,104.48 / $1,104.48
| Facility | | $1,080.61 | $1,104.48 | $1,104.48 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $108.86 / $108.86 / $108.86
| Facility | AS | $108.86 | $108.86 | $108.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $842.00 / $4,539.00 / $10,113.00
| Facility | | $842.00 | $4,539.00 | $10,113.00 |