- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $710.97 / $7,182.00 / $13,453.87
| Facility | | $710.97 | $7,182.00 | $13,453.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $505.00 / $505.00
| Facility | | $505.00 | $505.00 | $505.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $574.67 / $732.72 / $1,337.56
| Facility | | $574.67 | $732.72 | $1,337.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $94.82 / $97.94 / $150.52
| Facility | AS | $94.82 | $97.94 | $150.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $659.00 / $6,607.00 / $8,667.00
| Facility | | $659.00 | $6,607.00 | $8,667.00 |