- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,089.30 / $4,677.35 / $8,511.38
| Facility | | $2,089.30 | $4,677.35 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,238.72 / $4,677.35 / $8,912.51
| Facility | | $2,238.72 | $4,677.35 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $912.01 / $1,905.46 / $6,165.95
| Facility | | $912.01 | $1,905.46 | $6,165.95 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $323.59 / $575.44 / $575.44
| Facility | AS | $323.59 | $575.44 | $575.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,884.03 / $3,548.13 / $11,748.98
| Facility | | $2,884.03 | $3,548.13 | $11,748.98 |