- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $9,544.15 / $20,928.72
| Facility | | $5,463.36 | $9,544.15 | $20,928.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,838.93 / $11,364.26 / $19,943.52
| Facility | | $7,838.93 | $11,364.26 | $19,943.52 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $563.84 / $958.53 / $1,548.34
| Facility | | $563.84 | $958.53 | $1,548.34 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $905.99 / $905.99 / $905.99
| Facility | AS | $905.99 | $905.99 | $905.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,076.25 / $1,422.78 / $3,137.00
| Facility | | $1,076.25 | $1,422.78 | $3,137.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,700.00 / $6,178.00 / $8,632.00
| Facility | | $4,700.00 | $6,178.00 | $8,632.00 |