- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,041.74 / $3,890.45 / $7,943.28
| Facility | | $2,041.74 | $3,890.45 | $7,943.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $2,691.53 / $3,981.07
| Facility | | $831.76 | $2,691.53 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $831.76 / $1,230.27 / $2,238.72
| Facility | | $831.76 | $1,230.27 | $2,238.72 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $218.78 / $218.78 / $407.38
| Facility | AS | $218.78 | $218.78 | $407.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $1,230.27 / $2,187.76
| Facility | | $676.08 | $1,230.27 | $2,187.76 |