- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $5,370.32 / $8,709.64
| Facility | | $2,089.30 | $5,370.32 | $8,709.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $5,370.32 / $7,943.28
| Facility | | $1,659.59 | $5,370.32 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,737.80 / $10,715.19
| Facility | | $1,202.26 | $1,737.80 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $309.03 / $309.03 / $4,786.30
| Facility | AS | $309.03 | $309.03 | $4,786.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,495.41 / $8,709.64 / $12,022.64
| Facility | | $5,495.41 | $8,709.64 | $12,022.64 |