- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,237.63 / $3,921.00 / $7,467.00
| Facility | | $1,237.63 | $3,921.00 | $7,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $672.35 / $2,613.46 / $4,140.09
| Facility | | $672.35 | $2,613.46 | $4,140.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $609.66 / $808.30 / $9,251.00
| Facility | | $609.66 | $808.30 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $162.91 / $162.91 / $2,380.48
| Facility | AS | $162.91 | $162.91 | $2,380.48 |
- 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 |