- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $3,684.00 / $18,600.00
| Facility | | $1,346.00 | $3,684.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,003.53 / $18,972.31 / $30,208.54
| Facility | | $12,003.53 | $18,972.31 | $30,208.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,030.00 / $2,072.23 / $7,223.00
| Facility | | $1,030.00 | $2,072.23 | $7,223.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $713.16 / $713.16 / $713.16
| Facility | AS | $713.16 | $713.16 | $713.16 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $350.00 / $1,760.00 / $6,155.68
| Facility | | $350.00 | $1,760.00 | $6,155.68 |