- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $562.34 / $2,137.96 / $8,511.38
| Facility | | $562.34 | $2,137.96 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,244.36 / $10,715.19 / $11,220.18
| Facility | | $7,244.36 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $562.34 / $676.08
| Facility | | $398.11 | $562.34 | $676.08 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $758.58 / $758.58
| Facility | | $34.67 | $758.58 | $758.58 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $75.86 / $75.86 / $75.86
| Facility | AS | $75.86 | $75.86 | $75.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |