- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,578.85 / $2,747.00 / $5,454.00
| Facility | | $1,578.85 | $2,747.00 | $5,454.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,804.00 / $5,000.00 / $13,737.00
| Facility | | $1,804.00 | $5,000.00 | $13,737.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.34 / $380.34 / $762.69
| Facility | AS | $380.34 | $380.34 | $762.69 |
- 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
- $300.00 / $2,433.53 / $8,090.00
| Facility | | $300.00 | $2,433.53 | $8,090.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $6,238.00 / $17,462.00
| Facility | | $2,485.00 | $6,238.00 | $17,462.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $380.34 / $380.34 / $762.69
| Facility | AS | $380.34 | $380.34 | $762.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,485.00 / $6,474.00 / $13,737.00
| Facility | | $2,485.00 | $6,474.00 | $13,737.00 |