- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $1,778.28 / $8,128.31
| Facility | | $562.34 | $1,778.28 | $8,128.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,467.37 / $5,495.41 / $12,302.69
| Facility | | $3,467.37 | $5,495.41 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $436.52 / $602.56 / $776.25
| Facility | | $436.52 | $602.56 | $776.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $812.83 / $812.83
| Facility | | $34.67 | $812.83 | $812.83 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $81.28 / $81.28 / $81.28
| Facility | AS | $81.28 | $81.28 | $81.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |