- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,914.57 / $7,155.00 / $11,627.00
| Facility | | $1,914.57 | $7,155.00 | $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
- $1,894.41 / $2,066.63 / $3,009.30
| Facility | | $1,894.41 | $2,066.63 | $3,009.30 |
- 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
- $2,408.56 / $2,408.56 / $2,408.56
| Facility | | $2,408.56 | $2,408.56 | $2,408.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $238.75 / $238.75 / $238.75
| Facility | AS | $238.75 | $238.75 | $238.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,480.00 / $3,086.00 / $6,111.00
| Facility | | $1,480.00 | $3,086.00 | $6,111.00 |