- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,200.82 / $4,889.39 / $7,120.36
| Facility | | $2,200.82 | $4,889.39 | $7,120.36 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $679.78 / $1,099.88 / $2,533.04
| Professional | | $679.78 | $1,099.88 | $2,533.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,042.22 / $1,806.82 / $20,063.05
| Facility | | $1,042.22 | $1,806.82 | $20,063.05 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $5,333.89 / $5,333.89 / $5,333.89
| Facility | AS | $5,333.89 | $5,333.89 | $5,333.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,352.88 / $1,806.82 / $18,467.09
| Facility | | $1,352.88 | $1,806.82 | $18,467.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,220.00 / $9,259.00 / $14,242.22
| Facility | | $8,220.00 | $9,259.00 | $14,242.22 |