- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,084.93 / $2,678.00 / $7,602.00
| Facility | | $1,084.93 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,417.00 / $2,387.00 / $5,588.00
| Facility | | $1,417.00 | $2,387.00 | $5,588.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $17,035.36 / $17,449.59
| Facility | | $55.00 | $17,035.36 | $17,449.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $232.72 / $454.62 / $454.62
| Facility | AS | $232.72 | $454.62 | $454.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,052.00 / $10,886.00 / $20,054.00
| Facility | | $5,052.00 | $10,886.00 | $20,054.00 |