- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,521.00 / $9,112.00
| Facility | | $1,965.00 | $4,521.00 | $9,112.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,310.70 / $4,934.39 / $8,070.83
| Facility | | $1,310.70 | $4,934.39 | $8,070.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,387.05 / $1,850.42 / $16,556.00
| Facility | | $1,387.05 | $1,850.42 | $16,556.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $367.74 / $367.74 / $7,686.13
| Facility | AS | $367.74 | $367.74 | $7,686.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,600.00 / $12,113.00 / $16,987.00
| Facility | | $3,600.00 | $12,113.00 | $16,987.00 |