- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,235.94 / $10,471.29 / $18,197.01
| Facility | | $3,235.94 | $10,471.29 | $18,197.01 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,466.84 / $10,715.19 / $19,952.62
| Facility | | $4,466.84 | $10,715.19 | $19,952.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,137.96 / $14,791.08 / $15,488.17
| Facility | | $2,137.96 | $14,791.08 | $15,488.17 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $213.80 / $213.80 / $213.80
| Facility | AS | $213.80 | $213.80 | $213.80 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $1,949.84 / $1,949.84 / $2,884.03
| Professional | | $1,949.84 | $1,949.84 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,202.26 / $1,621.81 / $2,754.23
| Facility | | $1,202.26 | $1,621.81 | $2,754.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,677.35 / $18,197.01 / $25,703.96
| Facility | | $4,677.35 | $18,197.01 | $25,703.96 |