- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $5,946.00 / $12,600.00
| Facility | | $1,000.00 | $5,946.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,873.50 / $12,508.22 / $19,762.84
| Facility | | $7,873.50 | $12,508.22 | $19,762.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,274.28 / $7,274.28 / $7,274.28
| Facility | | $7,274.28 | $7,274.28 | $7,274.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $684.96 / $976.49 / $14,063.00
| Facility | | $684.96 | $976.49 | $14,063.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.67 / $2,425.91 / $2,425.91
| Facility | AS | $169.67 | $2,425.91 | $2,425.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $6,980.00 / $14,139.00
| Facility | | $1,851.00 | $6,980.00 | $14,139.00 |