- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,897.79 / $8,511.38
| Facility | | $2,137.96 | $4,897.79 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,897.79 / $10,000.00
| Facility | | $2,238.72 | $4,897.79 | $10,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $3,235.94 / $11,481.54
| Facility | | $54.95 | $3,235.94 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $602.56 / $1,174.90 / $1,174.90
| Facility | AS | $602.56 | $1,174.90 | $1,174.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,380.38 / $2,818.38 / $10,471.29
| Facility | | $1,380.38 | $2,818.38 | $10,471.29 |