- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $2,691.53 / $8,317.64
| Facility | | $389.05 | $2,691.53 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $8,511.38 / $77,624.71
| Facility | | $5,011.87 | $8,511.38 | $77,624.71 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $389.05 / $389.05 / $389.05
| Facility | | $389.05 | $389.05 | $389.05 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $245.47 / $245.47 / $245.47
| Facility | 62 | $245.47 | $245.47 | $245.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $38.90 / $38.90 / $38.90
| Facility | AS | $38.90 | $38.90 | $38.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,000.00 / $1,000.00 / $1,000.00
| Facility | | $1,000.00 | $1,000.00 | $1,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $426.58 / $2,344.23 / $8,317.64
| Facility | | $426.58 | $2,344.23 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $380.19 / $380.19 / $380.19
| Facility | | $380.19 | $380.19 | $380.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $208.93 / $208.93 / $223.87
| Facility | | $208.93 | $208.93 | $223.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $144.54 / $676.08 / $4,466.84
| Facility | | $144.54 | $676.08 | $4,466.84 |