- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,241.22 / $8,355.33 / $19,276.96
| Facility | | $4,241.22 | $8,355.33 | $19,276.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,619.76 / $8,706.79 / $16,841.75
| Facility | | $6,619.76 | $8,706.79 | $16,841.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,266.26 / $5,266.26 / $5,266.26
| Facility | | $5,266.26 | $5,266.26 | $5,266.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $963.05 / $1,745.22 / $10,575.11
| Facility | | $963.05 | $1,745.22 | $10,575.11 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $272.33 / $1,887.52 / $1,887.52
| Facility | AS | $272.33 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,947.22 / $2,777.31 / $6,616.19
| Facility | | $1,947.22 | $2,777.31 | $6,616.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,777.00 / $8,220.00 / $9,696.00
| Facility | | $6,777.00 | $8,220.00 | $9,696.00 |