- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,248.07 / $12,589.25
| Facility | | $1,202.26 | $5,248.07 | $12,589.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,801.89 / $10,964.78 / $22,908.68
| Facility | | $3,801.89 | $10,964.78 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,630.27 / $7,585.78
| Facility | | $630.96 | $2,630.27 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.91 / $147.91 / $147.91
| Facility | AS | $147.91 | $147.91 | $147.91 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,951.21 / $8,709.64 / $19,054.61
| Facility | | $2,951.21 | $8,709.64 | $19,054.61 |