- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,071.52 / $4,786.30 / $11,481.54
| Facility | | $1,071.52 | $4,786.30 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $10,232.93 / $22,387.21
| Facility | | $3,548.13 | $10,232.93 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $2,238.72 / $5,495.41
| Facility | | $912.01 | $2,238.72 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $123.03 / $123.03 / $123.03
| Facility | AS | $123.03 | $123.03 | $123.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $5,754.40 / $14,125.38
| Facility | | $1,949.84 | $5,754.40 | $14,125.38 |