- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,277.67 / $3,513.00 / $7,602.00
| Facility | | $1,277.67 | $3,513.00 | $7,602.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,430.00 / $5,500.00 / $9,419.00
| Facility | | $2,430.00 | $5,500.00 | $9,419.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,897.00 / $13,960.05 / $13,960.05
| Facility | | $5,897.00 | $13,960.05 | $13,960.05 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $265.13 / $1,324.34 / $1,324.34
| Facility | AS | $265.13 | $1,324.34 | $1,324.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,604.00 / $5,747.00 / $11,122.00
| Facility | | $3,604.00 | $5,747.00 | $11,122.00 |