- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $3,890.45 / $11,220.18
| Facility | | $891.25 | $3,890.45 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,388.44 / $5,248.07 / $8,511.38
| Facility | | $3,388.44 | $5,248.07 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $2,570.40 / $2,570.40
| Facility | | $2,570.40 | $2,570.40 | $2,570.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $1,047.13 / $6,760.83
| Facility | | $660.69 | $1,047.13 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.97 / $851.14 / $851.14
| Facility | AS | $181.97 | $851.14 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $575.44 / $2,089.30 / $4,073.80
| Facility | | $575.44 | $2,089.30 | $4,073.80 |