- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,742.00 / $18,600.00
| Facility | | $1,000.00 | $3,742.00 | $18,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $900.00 / $900.00 / $900.00
| Facility | | $900.00 | $900.00 | $900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $832.82 / $1,190.93 / $14,327.00
| Facility | | $832.82 | $1,190.93 | $14,327.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.46 / $354.84 / $354.84
| Facility | AS | $191.46 | $354.84 | $354.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,228.00 / $10,642.00 / $20,423.23
| Facility | | $3,228.00 | $10,642.00 | $20,423.23 |