- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $2,290.87 / $8,511.38
| Facility | | $812.83 | $2,290.87 | $8,511.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,606.93 / $10,715.19 / $11,220.18
| Facility | | $6,606.93 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $724.44 / $954.99 / $1,258.93
| Facility | | $724.44 | $954.99 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,445.44 / $1,445.44
| Facility | | $34.67 | $1,445.44 | $1,445.44 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.54 / $144.54 / $144.54
| Facility | AS | $144.54 | $144.54 | $144.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $524.81 / $1,348.96 / $5,248.07
| Facility | | $524.81 | $1,348.96 | $5,248.07 |