- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,474.00 / $7,960.15
| Facility | | $1,965.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,126.40 / $5,113.62
| Facility | | $830.45 | $3,126.40 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $730.33 / $984.00 / $6,063.00
| Facility | | $730.33 | $984.00 | $6,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $194.04 / $194.04 / $1,955.22
| Facility | AS | $194.04 | $194.04 | $1,955.22 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,892.00 / $4,545.00 / $7,217.00
| Facility | | $2,892.00 | $4,545.00 | $7,217.00 |