- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,174.90 / $3,467.37 / $6,760.83
| Facility | | $1,174.90 | $3,467.37 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,888.44 / $9,120.11 / $15,135.61
| Facility | | $5,888.44 | $9,120.11 | $15,135.61 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,489.63 / $13,489.63 / $13,489.63
| Facility | | $13,489.63 | $13,489.63 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $1,862.09 / $7,943.28
| Facility | | $1,047.13 | $1,862.09 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $288.40 / $4,570.88 / $4,570.88
| Facility | AS | $288.40 | $4,570.88 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,230.27 / $4,677.35 / $8,709.64
| Facility | | $1,230.27 | $4,677.35 | $8,709.64 |