- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $7,838.38 / $7,838.38
| Facility | | $1,000.00 | $7,838.38 | $7,838.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,106.46 / $10,791.27 / $17,368.09
| Facility | | $2,106.46 | $10,791.27 | $17,368.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $723.23 / $723.23 / $1,996.40
| Facility | | $723.23 | $723.23 | $1,996.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $71.36 / $71.36 / $71.36
| Facility | AS | $71.36 | $71.36 | $71.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $598.32 / $749.60 / $972.40
| Facility | | $598.32 | $749.60 | $972.40 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $71.36 / $71.36 / $71.36
| Facility | AS | $71.36 | $71.36 | $71.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.00 / $9,127.00 / $15,435.11
| Facility | | $1,230.00 | $9,127.00 | $15,435.11 |