- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,617.00 / $7,562.14
| Facility | | $1,671.00 | $3,617.00 | $7,562.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,805.25 / $6,640.00 / $10,860.55
| Facility | | $1,805.25 | $6,640.00 | $10,860.55 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,501.92 / $2,132.00 / $4,435.00
| Facility | | $1,501.92 | $2,132.00 | $4,435.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $393.06 / $393.06 / $733.29
| Facility | AS | $393.06 | $393.06 | $733.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,424.00 / $3,269.00 / $6,416.00
| Facility | | $1,424.00 | $3,269.00 | $6,416.00 |