- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $5,754.40 / $13,489.63
| Facility | | $1,202.26 | $5,754.40 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,548.13 / $9,772.37 / $18,620.87
| Facility | | $3,548.13 | $9,772.37 | $18,620.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $398.11 / $1,122.02 / $5,370.32
| Facility | | $398.11 | $1,122.02 | $5,370.32 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $112.20 / $112.20 / $112.20
| Facility | AS | $112.20 | $112.20 | $112.20 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $7,762.47 / $17,782.79
| Facility | | $2,137.96 | $7,762.47 | $17,782.79 |