- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $933.25 / $4,265.80 / $10,471.29
| Facility | | $933.25 | $4,265.80 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $173.78 / $489.78 / $1,862.09
| Facility | | $173.78 | $489.78 | $1,862.09 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $17.38 / $17.38 / $17.38
| Facility | AS | $17.38 | $17.38 | $17.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,630.27 / $2,754.23 / $3,019.95
| Facility | | $2,630.27 | $2,754.23 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $346.74 / $1,778.28 / $4,168.69
| Facility | | $346.74 | $1,778.28 | $4,168.69 |