- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,524.45 / $5,522.00 / $11,171.50
| Facility | | $1,524.45 | $5,522.00 | $11,171.50 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $6,443.89 / $12,040.00 / $23,008.27
| Facility | | $6,443.89 | $12,040.00 | $23,008.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,876.05 / $1,876.05 / $7,157.00
| Facility | | $1,876.05 | $1,876.05 | $7,157.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $133.02 / $133.02 / $133.02
| Facility | AS | $133.02 | $133.02 | $133.02 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,206.00 / $6,759.00 / $12,241.00
| Facility | | $3,206.00 | $6,759.00 | $12,241.00 |