- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,393.02 / $4,430.50 / $9,111.25
| Facility | | $1,393.02 | $4,430.50 | $9,111.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,093.00 / $9,565.00 / $16,490.00
| Facility | | $6,093.00 | $9,565.00 | $16,490.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,341.75 / $1,881.31 / $4,166.05
| Facility | | $1,341.75 | $1,881.31 | $4,166.05 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $133.40 / $133.40 / $133.40
| Facility | AS | $133.40 | $133.40 | $133.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.00 / $5,111.00 / $9,202.00
| Facility | | $2,200.00 | $5,111.00 | $9,202.00 |