- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $2,398.83 / $6,456.54
| Facility | | $891.25 | $2,398.83 | $6,456.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $8,128.31 / $13,489.63
| Facility | | $2,238.72 | $8,128.31 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $30.20 / $30.20 / $30.20
| Facility | | $30.20 | $30.20 | $30.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $45,708.82 / $47,863.01 / $47,863.01
| Facility | | $45,708.82 | $47,863.01 | $47,863.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $4,786.30 / $4,786.30 / $4,786.30
| Facility | AS | $4,786.30 | $4,786.30 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,570.88 / $7,585.78
| Facility | | $2,754.23 | $4,570.88 | $7,585.78 |