- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,440.28 / $5,719.00 / $16,900.00
| Facility | | $1,440.28 | $5,719.00 | $16,900.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,516.12 / $11,671.64 / $18,341.14
| Facility | | $7,516.12 | $11,671.64 | $18,341.14 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,036.67 / $1,579.40 / $8,325.59
| Facility | | $1,036.67 | $1,579.40 | $8,325.59 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $464.74 / $464.74 / $464.74
| Facility | AS | $464.74 | $464.74 | $464.74 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,091.00 / $4,054.00 / $7,077.94
| Facility | | $1,091.00 | $4,054.00 | $7,077.94 |