- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,001.47 / $1,001.47 / $18,750.83
| Facility | | $1,001.47 | $1,001.47 | $18,750.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,818.28 / $22,439.74 / $46,771.99
| Facility | | $4,818.28 | $22,439.74 | $46,771.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,429.52 / $3,447.14 / $8,292.56
| Facility | | $2,429.52 | $3,447.14 | $8,292.56 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $113.45 / $113.45 / $113.45
| Facility | AS | $113.45 | $113.45 | $113.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,208.66 / $3,151.51 / $6,529.58
| Facility | | $2,208.66 | $3,151.51 | $6,529.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,058.08 / $1,740.11 / $8,313.37
| Facility | | $1,058.08 | $1,740.11 | $8,313.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $258.20 / $258.20 / $258.20
| Facility | AS | $258.20 | $258.20 | $258.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,577.00 / $10,743.00 / $13,109.00
| Facility | | $5,577.00 | $10,743.00 | $13,109.00 |