- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,346.00 / $4,374.00 / $29,973.74
| Facility | | $1,346.00 | $4,374.00 | $29,973.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $11,271.71 / $17,815.62 / $28,366.81
| Facility | | $11,271.71 | $17,815.62 | $28,366.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,321.00 / $2,321.00 / $2,321.00
| Facility | | $2,321.00 | $2,321.00 | $2,321.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,415.00 / $2,709.00 / $7,077.94
| Facility | | $1,415.00 | $2,709.00 | $7,077.94 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $881.80 / $881.80 / $881.80
| Facility | AS | $881.80 | $881.80 | $881.80 |
- 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 |