- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,821.00 / $2,678.00 / $7,602.00
| Facility | | $1,821.00 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,275.00 / $2,326.00 / $4,528.00
| Facility | | $1,275.00 | $2,326.00 | $4,528.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $16,502.08 / $16,871.84
| Facility | | $55.00 | $16,502.08 | $16,871.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $225.89 / $441.43 / $441.43
| Facility | AS | $225.89 | $441.43 | $441.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $2,665.00 / $4,918.00
| Facility | | $1,200.00 | $2,665.00 | $4,918.00 |