- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,574.52 / $3,477.00 / $7,467.00
| Facility | | $1,574.52 | $3,477.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,531.19 / $4,140.09
| Facility | | $672.35 | $2,531.19 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $775.63 / $1,130.22 / $7,167.00
| Facility | | $775.63 | $1,130.22 | $7,167.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $206.69 / $206.69 / $2,537.14
| Facility | AS | $206.69 | $206.69 | $2,537.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,759.00 / $6,091.14 / $9,010.00
| Facility | | $4,759.00 | $6,091.14 | $9,010.00 |