- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,905.83 / $8,483.04 / $58,311.96
| Facility | | $4,905.83 | $8,483.04 | $58,311.96 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $974.38 / $1,097.02 / $1,195.21
| Facility | | $974.38 | $1,097.02 | $1,195.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,044.80 / $1,044.80 / $1,044.80
| Facility | | $1,044.80 | $1,044.80 | $1,044.80 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $102.86 / $102.86 / $102.86
| Facility | AS | $102.86 | $102.86 | $102.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $14,541.01 / $28,032.67 / $33,149.33
| Facility | | $14,541.01 | $28,032.67 | $33,149.33 |