- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,463.36 / $10,506.16 / $21,899.37
| Facility | | $5,463.36 | $10,506.16 | $21,899.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,732.29 / $13,189.77 / $24,760.56
| Facility | | $9,732.29 | $13,189.77 | $24,760.56 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $895.76 / $1,596.36 / $13,486.75
| Facility | | $895.76 | $1,596.36 | $13,486.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $1,279.44 / $1,279.44 / $1,279.44
| Facility | AS | $1,279.44 | $1,279.44 | $1,279.44 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,590.00 / $2,056.52 / $2,804.84
| Facility | | $1,590.00 | $2,056.52 | $2,804.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,178.00 / $7,441.00 / $8,816.00
| Facility | | $6,178.00 | $7,441.00 | $8,816.00 |