- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,584.89 / $2,951.21
| Facility | | $831.76 | $1,584.89 | $2,951.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,762.47 / $9,120.11 / $12,302.69
| Facility | | $7,762.47 | $9,120.11 | $12,302.69 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $1,698.24 / $1,698.24
| Facility | | $1,698.24 | $1,698.24 | $1,698.24 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $169.82 / $169.82 / $169.82
| Facility | AS | $169.82 | $169.82 | $169.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,698.24 / $5,248.07 / $8,709.64
| Facility | | $1,698.24 | $5,248.07 | $8,709.64 |