- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $6,606.93 / $26,302.68
| Facility | | $1,000.00 | $6,606.93 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $489.78 / $4,677.35 / $5,623.41
| Facility | | $489.78 | $4,677.35 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $154.88 / $154.88 / $154.88
| Facility | AS | $154.88 | $154.88 | $154.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,165.95 / $12,022.64 / $22,908.68
| Facility | | $6,165.95 | $12,022.64 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,365.16 / $12,302.69 / $18,620.87
| Facility | | $4,365.16 | $12,302.69 | $18,620.87 |