- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $126.54 / $2,336.67 / $3,140.53
| Facility | | $126.54 | $2,336.67 | $3,140.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $317.06 / $374.00 / $526.19
| Facility | | $317.06 | $374.00 | $526.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $120.82 / $120.82 / $120.82
| Facility | | $120.82 | $120.82 | $120.82 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $11.78 / $11.78 / $11.78
| Facility | AS | $11.78 | $11.78 | $11.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $116.59 / $2,056.00 / $4,933.00
| Facility | | $116.59 | $2,056.00 | $4,933.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $464.00 / $1,438.00 / $2,029.00
| Facility | | $464.00 | $1,438.00 | $2,029.00 |