- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,096.48 / $1,096.48 / $1,096.48
| Facility | | $1,096.48 | $1,096.48 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $2,238.72 / $8,912.51
| Facility | | $977.24 | $2,238.72 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,511.89 / $3,630.78 / $8,511.38
| Facility | | $2,511.89 | $3,630.78 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $181.97 / $181.97 / $181.97
| Facility | AS | $181.97 | $181.97 | $181.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,754.23 / $3,467.37 / $6,760.83
| Facility | | $2,754.23 | $3,467.37 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $1,995.26 / $3,981.07
| Facility | | $1,513.56 | $1,995.26 | $3,981.07 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,467.37 / $8,511.38
| Facility | | $1,584.89 | $3,467.37 | $8,511.38 |