- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,219.29 / $3,694.57 / $8,094.57
| Facility | | $1,219.29 | $3,694.57 | $8,094.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,452.00 / $7,363.00 / $12,538.00
| Facility | | $4,452.00 | $7,363.00 | $12,538.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,231.21 / $1,231.21 / $3,263.34
| Facility | | $1,231.21 | $1,231.21 | $3,263.34 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $119.30 / $119.30 / $119.30
| Facility | AS | $119.30 | $119.30 | $119.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,292.00 / $3,325.00 / $8,198.00
| Facility | | $1,292.00 | $3,325.00 | $8,198.00 |