- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $4,786.30 / $11,748.98
| Facility | | $1,000.00 | $4,786.30 | $11,748.98 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,090.30 / $8,317.64 / $15,488.17
| Facility | | $3,090.30 | $8,317.64 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,584.89 / $3,890.45
| Facility | | $660.69 | $1,584.89 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $91.20 / $91.20 / $91.20
| Facility | AS | $91.20 | $91.20 | $91.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,265.80 / $10,000.00
| Facility | | $1,513.56 | $4,265.80 | $10,000.00 |