- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,354.00 / $5,658.57 / $14,557.60
| Facility | | $1,354.00 | $5,658.57 | $14,557.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,276.00 / $6,366.00 / $9,283.00
| Facility | | $3,276.00 | $6,366.00 | $9,283.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $8,112.30 / $21,000.00
| Facility | | $55.00 | $8,112.30 | $21,000.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $258.23 / $500.32 / $500.32
| Facility | AS | $258.23 | $500.32 | $500.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,259.00 / $4,567.00 / $7,669.00
| Facility | | $2,259.00 | $4,567.00 | $7,669.00 |