- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,047.13 / $5,128.61 / $11,481.54
| Facility | | $1,047.13 | $5,128.61 | $11,481.54 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $323.59 / $426.58 / $4,168.69
| Facility | | $323.59 | $426.58 | $4,168.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $42.66 / $42.66 / $42.66
| Facility | AS | $42.66 | $42.66 | $42.66 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,348.96 / $2,630.27 / $6,309.57
| Facility | | $1,348.96 | $2,630.27 | $6,309.57 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $331.13 / $1,737.80 / $4,168.69
| Facility | | $331.13 | $1,737.80 | $4,168.69 |