- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $3,801.89 / $7,413.10
| Facility | | $1,513.56 | $3,801.89 | $7,413.10 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $630.96 / $2,041.74 / $3,019.95
| Facility | | $630.96 | $2,041.74 | $3,019.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $537.03 / $794.33 / $6,309.57
| Facility | | $537.03 | $794.33 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.54 / $144.54 / $851.14
| Facility | AS | $144.54 | $144.54 | $851.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $4,073.80 / $7,244.36
| Facility | | $2,754.23 | $4,073.80 | $7,244.36 |