- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $7,413.10 / $14,454.40
| Facility | | $660.69 | $7,413.10 | $14,454.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $724.44 / $870.96
| Facility | | $724.44 | $724.44 | $870.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,148.15 / $1,148.15 / $2,290.87
| Facility | | $1,148.15 | $1,148.15 | $2,290.87 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $114.82 / $114.82 / $114.82
| Facility | AS | $114.82 | $114.82 | $114.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $3,548.13 / $20,417.38
| Facility | | $3,548.13 | $3,548.13 | $20,417.38 |