- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,528.00 / $2,894.76 / $7,625.00
| Facility | | $2,528.00 | $2,894.76 | $7,625.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,524.57 / $4,359.46 / $13,890.09
| Facility | | $1,524.57 | $4,359.46 | $13,890.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $335.89 / $335.89 / $672.91
| Facility | AS | $335.89 | $335.89 | $672.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,000.00 / $2,000.00 / $3,000.00
| Facility | | $2,000.00 | $2,000.00 | $3,000.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,355.71 / $2,193.50 / $6,679.00
| Facility | | $1,355.71 | $2,193.50 | $6,679.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,401.43 / $6,513.26 / $18,259.27
| Facility | | $6,401.43 | $6,513.26 | $18,259.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $4,525.00 / $11,709.27
| Facility | | $1,902.00 | $4,525.00 | $11,709.27 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $335.89 / $335.89 / $672.91
| Facility | AS | $335.89 | $335.89 | $672.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,902.00 / $3,764.00 / $8,766.00
| Facility | | $1,902.00 | $3,764.00 | $8,766.00 |