- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $758.58 / $1,949.84 / $9,120.11
| Facility | | $758.58 | $1,949.84 | $9,120.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $4,073.80 / $9,549.93
| Facility | | $2,630.27 | $4,073.80 | $9,549.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $912.01 / $1,202.26
| Facility | | $660.69 | $912.01 | $1,202.26 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $1,258.93 / $2,290.87
| Facility | | $1,258.93 | $1,258.93 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.89 / $125.89 / $125.89
| Facility | AS | $125.89 | $125.89 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |