- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $3,576.00 / $8,400.00
| Facility | | $1,000.00 | $3,576.00 | $8,400.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,365.01 / $8,331.20 / $13,091.91
| Facility | | $5,365.01 | $8,331.20 | $13,091.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $427.63 / $1,688.13 / $7,214.89
| Facility | | $427.63 | $1,688.13 | $7,214.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $826.90 / $826.90 / $826.90
| Facility | AS | $826.90 | $826.90 | $826.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,091.00 / $4,054.00 / $7,077.94
| Facility | | $1,091.00 | $4,054.00 | $7,077.94 |