- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $3,235.94 / $9,772.37
| Facility | | $549.54 | $3,235.94 | $9,772.37 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,570.40 / $4,786.30 / $13,803.84
| Facility | | $2,570.40 | $4,786.30 | $13,803.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $34.67 / $660.69 / $1,819.70
| Facility | | $34.67 | $660.69 | $1,819.70 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $39.81 / $39.81 / $39.81
| Facility | AS | $39.81 | $39.81 | $39.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $295.12 / $1,202.26 / $3,630.78
| Facility | | $295.12 | $1,202.26 | $3,630.78 |