- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,819.70 / $5,623.41 / $14,454.40
| Facility | | $1,819.70 | $5,623.41 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,265.80 / $12,882.50 / $28,840.32
| Facility | | $4,265.80 | $12,882.50 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $4,365.16 / $12,302.69
| Facility | | $323.59 | $4,365.16 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $302.00 / $302.00 / $302.00
| Facility | AS | $302.00 | $302.00 | $302.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $11,481.54 / $27,542.29
| Facility | | $3,548.13 | $11,481.54 | $27,542.29 |