- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $5,754.40 / $15,488.17
| Facility | | $1,778.28 | $5,754.40 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,981.07 / $14,125.38 / $28,840.32
| Facility | | $3,981.07 | $14,125.38 | $28,840.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $4,570.88 / $16,595.87
| Facility | | $630.96 | $4,570.88 | $16,595.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $288.40 / $288.40 / $288.40
| Facility | AS | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $11,481.54 / $31,622.78
| Facility | | $3,548.13 | $11,481.54 | $31,622.78 |