- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $4,897.79 / $7,244.36
| Facility | | $891.25 | $4,897.79 | $7,244.36 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,344.23 / $8,317.64 / $10,471.29
| Facility | | $2,344.23 | $8,317.64 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $812.83 / $933.25
| Facility | | $794.33 | $812.83 | $933.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.83 / $1,318.26 / $1,659.59
| Facility | | $812.83 | $1,318.26 | $1,659.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $138.04 / $138.04 / $138.04
| Facility | AS | $138.04 | $138.04 | $138.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,290.87 / $7,762.47 / $10,964.78
| Facility | | $2,290.87 | $7,762.47 | $10,964.78 |