- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,707.83 / $6,021.00 / $11,627.00
| Facility | | $1,707.83 | $6,021.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,670.00 / $6,746.00 / $30,285.00
| Facility | | $2,670.00 | $6,746.00 | $30,285.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,141.73 / $1,245.53 / $1,813.67
| Facility | | $1,141.73 | $1,245.53 | $1,813.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $21,571.00 / $21,571.00 / $21,571.00
| Facility | | $21,571.00 | $21,571.00 | $21,571.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,446.52 / $1,446.52 / $1,446.52
| Facility | | $1,446.52 | $1,446.52 | $1,446.52 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $143.87 / $143.87 / $143.87
| Facility | AS | $143.87 | $143.87 | $143.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,070.00 / $8,440.00 / $13,382.00
| Facility | | $4,070.00 | $8,440.00 | $13,382.00 |