- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,778.28 / $3,548.13 / $7,943.28
| Facility | | $1,778.28 | $3,548.13 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $4,677.35 / $8,317.64
| Facility | | $2,137.96 | $4,677.35 | $8,317.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,412.54 / $26,302.68
| Facility | | $741.31 | $1,412.54 | $26,302.68 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $208.93 / $2,511.89 / $2,511.89
| Facility | AS | $208.93 | $2,511.89 | $2,511.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,454.71 / $3,715.35 / $6,165.95
| Facility | | $2,454.71 | $3,715.35 | $6,165.95 |