- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,266.51 / $3,695.07 / $8,074.63
| Facility | | $1,266.51 | $3,695.07 | $8,074.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,636.21 / $8,766.98 / $14,467.75
| Facility | | $4,636.21 | $8,766.98 | $14,467.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,259.08 / $1,259.08 / $3,338.58
| Facility | | $1,259.08 | $1,259.08 | $3,338.58 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $122.02 / $122.02 / $122.02
| Facility | AS | $122.02 | $122.02 | $122.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,403.00 / $3,325.00 / $8,198.00
| Facility | | $1,403.00 | $3,325.00 | $8,198.00 |