- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,255.18 / $2,678.00 / $7,602.00
| Facility | | $1,255.18 | $2,678.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $108.00 / $139.00 / $388.00
| Facility | | $108.00 | $139.00 | $388.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $2,891.40 / $2,978.39
| Facility | | $55.00 | $2,891.40 | $2,978.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $154.60 / $297.83 / $297.83
| Facility | AS | $154.60 | $297.83 | $297.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,233.00 / $2,665.00 / $4,918.00
| Facility | | $1,233.00 | $2,665.00 | $4,918.00 |