- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $851.14 / $3,630.78 / $10,471.29
| Facility | | $851.14 | $3,630.78 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,011.87 / $10,715.19 / $11,220.18
| Facility | | $5,011.87 | $10,715.19 | $11,220.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $660.69 / $933.25 / $1,096.48
| Facility | | $660.69 | $933.25 | $1,096.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $891.25 / $1,258.93
| Facility | | $34.67 | $891.25 | $1,258.93 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $125.89 / $125.89 / $125.89
| Facility | AS | $125.89 | $125.89 | $125.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $3,890.45 / $8,511.38
| Facility | | $741.31 | $3,890.45 | $8,511.38 |