- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,752.39 / $6,582.00 / $11,627.00
| Facility | | $1,752.39 | $6,582.00 | $11,627.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,794.51 / $17,502.61 / $31,141.30
| Facility | | $6,794.51 | $17,502.61 | $31,141.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,734.50 / $1,892.18 / $2,755.27
| Facility | | $1,734.50 | $1,892.18 | $2,755.27 |
- 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
- $2,219.06 / $2,219.06 / $2,219.06
| Facility | | $2,219.06 | $2,219.06 | $2,219.06 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.70 / $218.70 / $218.70
| Facility | AS | $218.70 | $218.70 | $218.70 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,771.00 / $3,098.00 / $6,111.00
| Facility | | $1,771.00 | $3,098.00 | $6,111.00 |