- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,785.00 / $6,329.00
| Facility | | $1,671.00 | $3,785.00 | $6,329.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,713.13 / $4,193.09
| Facility | | $672.35 | $2,713.13 | $4,193.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $652.27 / $864.03 / $9,251.00
| Facility | | $652.27 | $864.03 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $174.07 / $174.07 / $2,401.96
| Facility | AS | $174.07 | $174.07 | $2,401.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,279.00 / $7,341.00 / $11,396.00
| Facility | | $5,279.00 | $7,341.00 | $11,396.00 |