- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,422.06 / $4,487.00 / $8,941.07
| Facility | | $1,422.06 | $4,487.00 | $8,941.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,996.00 / $9,565.00 / $17,774.00
| Facility | | $6,996.00 | $9,565.00 | $17,774.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,211.00 / $3,851.90 / $5,577.46
| Facility | | $2,211.00 | $3,851.90 | $5,577.46 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $139.43 / $139.43 / $139.43
| Facility | AS | $139.43 | $139.43 | $139.43 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $8,072.00 / $14,716.00
| Facility | | $3,028.00 | $8,072.00 | $14,716.00 |