- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,909.00 / $12,600.00
| Facility | | $1,000.00 | $3,909.00 | $12,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,997.28 / $12,508.22 / $19,618.43
| Facility | | $7,997.28 | $12,508.22 | $19,618.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,659.86 / $5,659.86 / $5,659.86
| Facility | | $5,659.86 | $5,659.86 | $5,659.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $791.26 / $1,100.00 / $11,495.55
| Facility | | $791.26 | $1,100.00 | $11,495.55 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $193.64 / $1,887.52 / $1,887.52
| Facility | AS | $193.64 | $1,887.52 | $1,887.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,851.00 / $7,074.00 / $14,139.00
| Facility | | $1,851.00 | $7,074.00 | $14,139.00 |