- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $676.08 / $2,691.53 / $7,585.78
| Facility | | $676.08 | $2,691.53 | $7,585.78 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,454.71 / $5,623.41
| Facility | | $1,258.93 | $2,454.71 | $5,623.41 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $794.33 / $794.33
| Facility | | $794.33 | $794.33 | $794.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $54.95 / $1,584.89 / $1,584.89
| Facility | | $54.95 | $1,584.89 | $1,584.89 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $158.49 / $158.49 / $158.49
| Facility | AS | $158.49 | $158.49 | $158.49 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,332.54 / $15,135.61 / $34,673.69
| Facility | | $9,332.54 | $15,135.61 | $34,673.69 |