- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,875.15 / $6,620.88 / $26,079.36
| Facility | | $3,875.15 | $6,620.88 | $26,079.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $796.48 / $884.48 / $963.67
| Facility | | $796.48 | $884.48 | $963.67 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $857.80 / $857.80 / $857.80
| Facility | | $857.80 | $857.80 | $857.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.30 / $85.30 / $85.30
| Facility | AS | $85.30 | $85.30 | $85.30 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,015.67 / $7,015.67 / $7,015.67
| Facility | | $7,015.67 | $7,015.67 | $7,015.67 |