- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $44,668.36 / $53,703.18
| Facility | | $4,570.88 | $44,668.36 | $53,703.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,570.88 / $4,570.88 / $4,570.88
| Facility | | $4,570.88 | $4,570.88 | $4,570.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $891.25 / $891.25 / $2,884.03
| Facility | | $891.25 | $891.25 | $2,884.03 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $288.40 / $288.40 / $288.40
| Facility | AS | $288.40 | $288.40 | $288.40 |
- Facility/Professional
- Professional
- Modifier
- Low / Median / High Price
- $2,818.38 / $2,818.38 / $3,890.45
| Professional | | $2,818.38 | $2,818.38 | $3,890.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $2,238.72 / $3,801.89
| Facility | | $1,659.59 | $2,238.72 | $3,801.89 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,479.11 / $6,918.31 / $18,197.01
| Facility | | $1,479.11 | $6,918.31 | $18,197.01 |