- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,095.48 / $2,747.14 / $7,602.00
| Facility | | $2,095.48 | $2,747.14 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,270.00 / $2,324.00 / $4,372.00
| Facility | | $1,270.00 | $2,324.00 | $4,372.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $12,988.80 / $13,344.03
| Facility | | $55.00 | $12,988.80 | $13,344.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $312.68 / $603.20 / $603.20
| Facility | AS | $312.68 | $603.20 | $603.20 |
- 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 |