- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.59 / $8,477.27 / $20,928.72
| Facility | | $251.59 | $8,477.27 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,766.83 / $15,476.59 / $29,936.73
| Facility | | $11,766.83 | $15,476.59 | $29,936.73 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $251.59 / $440.28 / $4,317.00
| Facility | | $251.59 | $440.28 | $4,317.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $69.92 / $133.22 / $133.22
| Facility | AS | $69.92 | $133.22 | $133.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $332.39 / $640.46 / $903.10
| Facility | | $332.39 | $640.46 | $903.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,054.00 / $4,317.00 / $13,909.00
| Facility | | $3,054.00 | $4,317.00 | $13,909.00 |