- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,671.00 / $3,819.00 / $7,960.15
| Facility | | $1,671.00 | $3,819.00 | $7,960.15 |
- 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
- $1,108.03 / $1,670.91 / $4,435.00
| Facility | | $1,108.03 | $1,670.91 | $4,435.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $258.60 / $258.60 / $485.03
| Facility | AS | $258.60 | $258.60 | $485.03 |
- 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 |