- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,513.56 / $4,570.88 / $11,481.54
| Facility | | $1,513.56 | $4,570.88 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,890.45 / $9,772.37 / $17,782.79
| Facility | | $3,890.45 | $9,772.37 | $17,782.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $3,890.45 / $10,715.19
| Facility | | $323.59 | $3,890.45 | $10,715.19 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $229.09 / $229.09 / $229.09
| Facility | AS | $229.09 | $229.09 | $229.09 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,162.28 / $10,232.93
| Facility | | $851.14 | $3,162.28 | $10,232.93 |