- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,965.00 / $4,474.00 / $7,960.15
| Facility | | $1,965.00 | $4,474.00 | $7,960.15 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $830.45 / $3,126.40 / $5,113.62
| Facility | | $830.45 | $3,126.40 | $5,113.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $709.36 / $955.02 / $9,251.00
| Facility | | $709.36 | $955.02 | $9,251.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $189.25 / $189.25 / $2,579.65
| Facility | AS | $189.25 | $189.25 | $2,579.65 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,408.00 / $7,457.00 / $11,396.00
| Facility | | $5,408.00 | $7,457.00 | $11,396.00 |