- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,023.29 / $4,466.84 / $10,964.78
| Facility | | $1,023.29 | $4,466.84 | $10,964.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $10,964.78 / $22,387.21
| Facility | | $3,890.45 | $10,964.78 | $22,387.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,949.84 / $5,495.41
| Facility | | $398.11 | $1,949.84 | $5,495.41 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $134.90 / $134.90 / $134.90
| Facility | AS | $134.90 | $134.90 | $134.90 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,630.78 / $10,232.93 / $23,988.33
| Facility | | $3,630.78 | $10,232.93 | $23,988.33 |