- 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
- $1,417.00 / $2,388.00 / $5,611.00
| Facility | | $1,417.00 | $2,388.00 | $5,611.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $16,596.80 / $16,984.32
| Facility | | $55.00 | $16,596.80 | $16,984.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $226.84 / $443.03 / $443.03
| Facility | AS | $226.84 | $443.03 | $443.03 |
- 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 |