- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,258.93 / $2,630.27 / $8,912.51
| Facility | | $1,258.93 | $2,630.27 | $8,912.51 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $8,912.51 / $13,803.84 / $22,908.68
| Facility | | $8,912.51 | $13,803.84 | $22,908.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $5,754.40 / $5,754.40
| Facility | | $891.25 | $5,754.40 | $5,754.40 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,412.54 / $2,511.89 / $13,489.63
| Facility | | $1,412.54 | $2,511.89 | $13,489.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $371.54 / $1,621.81 / $1,621.81
| Facility | AS | $371.54 | $1,621.81 | $1,621.81 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,949.84 / $8,709.64 / $14,454.40
| Facility | | $1,949.84 | $8,709.64 | $14,454.40 |