- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,248.00 / $5,946.00 / $17,600.00
| Facility | | $1,248.00 | $5,946.00 | $17,600.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,211.26 / $14,558.95 / $23,181.40
| Facility | | $9,211.26 | $14,558.95 | $23,181.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,153.48 / $2,008.81 / $11,615.00
| Facility | | $1,153.48 | $2,008.81 | $11,615.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $597.35 / $597.35 / $597.35
| Facility | AS | $597.35 | $597.35 | $597.35 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,940.00 / $8,414.00 / $14,587.03
| Facility | | $1,940.00 | $8,414.00 | $14,587.03 |