- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $588.84 / $5,495.41 / $8,128.31
| Facility | | $588.84 | $5,495.41 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $7,585.78 / $14,791.08
| Facility | | $3,467.37 | $7,585.78 | $14,791.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $2,187.76 / $5,128.61
| Facility | | $1,513.56 | $2,187.76 | $5,128.61 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $100.00 / $100.00 / $100.00
| Facility | AS | $100.00 | $100.00 | $100.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,089.30 / $4,073.80
| Facility | | $1,659.59 | $2,089.30 | $4,073.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $602.56 / $1,202.26 / $6,918.31
| Facility | | $602.56 | $1,202.26 | $6,918.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $6,760.83 / $10,000.00
| Facility | | $3,388.44 | $6,760.83 | $10,000.00 |