- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $2,041.74 / $8,128.31
| Facility | | $2,041.74 | $2,041.74 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $12,589.25 / $38,904.51 / $83,176.38
| Facility | | $12,589.25 | $38,904.51 | $83,176.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,128.61 / $7,244.36 / $17,378.01
| Facility | | $5,128.61 | $7,244.36 | $17,378.01 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $354.81 / $354.81 / $354.81
| Facility | AS | $354.81 | $354.81 | $354.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,623.41 / $7,079.46 / $13,803.84
| Facility | | $5,623.41 | $7,079.46 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $3,801.89 / $7,585.78
| Facility | | $2,137.96 | $3,801.89 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $8,128.31 / $28,183.83
| Facility | | $1,584.89 | $8,128.31 | $28,183.83 |