- 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
- $11,977.92 / $18,931.83 / $30,144.09
| Facility | | $11,977.92 | $18,931.83 | $30,144.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $858.26 / $1,640.90 / $19,869.87
| Facility | | $858.26 | $1,640.90 | $19,869.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $5,739.78 / $5,739.78 / $5,739.78
| Facility | AS | $5,739.78 | $5,739.78 | $5,739.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,917.00 / $13,937.00 / $21,546.61
| Facility | | $3,917.00 | $13,937.00 | $21,546.61 |