- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,619.34 / $2,683.00 / $7,602.00
| Facility | | $1,619.34 | $2,683.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,375.00 / $2,324.00 / $4,124.00
| Facility | | $1,375.00 | $2,324.00 | $4,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $11,475.10 / $11,737.70
| Facility | | $55.00 | $11,475.10 | $11,737.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $193.26 / $377.83 / $377.83
| Facility | AS | $193.26 | $377.83 | $377.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,200.00 / $2,665.00 / $4,918.00
| Facility | | $1,200.00 | $2,665.00 | $4,918.00 |