- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $452.00 / $2,258.00 / $7,602.00
| Facility | | $452.00 | $2,258.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.00 / $147.00 / $2,367.00
| Facility | | $108.00 | $147.00 | $2,367.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.00 / $30.00 / $30.00
| Facility | | $30.00 | $30.00 | $30.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $437.41 / $1,300.00 / $2,000.00
| Facility | | $437.41 | $1,300.00 | $2,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $43.74 / $86.38 / $86.38
| Facility | AS | $43.74 | $86.38 | $86.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,426.00 / $4,722.00 / $7,669.00
| Facility | | $2,426.00 | $4,722.00 | $7,669.00 |