- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $794.33 / $2,818.38 / $10,471.29
| Facility | | $794.33 | $2,818.38 | $10,471.29 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,073.80 / $7,079.46 / $14,125.38
| Facility | | $4,073.80 | $7,079.46 | $14,125.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,047.13 / $1,230.27
| Facility | | $741.31 | $1,047.13 | $1,230.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $1,412.54 / $1,412.54
| Facility | | $34.67 | $1,412.54 | $1,412.54 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $141.25 / $141.25 / $141.25
| Facility | AS | $141.25 | $141.25 | $141.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $977.24 / $5,011.87 / $12,302.69
| Facility | | $977.24 | $5,011.87 | $12,302.69 |