- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,910.81 / $3,780.50 / $7,879.32
| Facility | | $1,910.81 | $3,780.50 | $7,879.32 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $7,754.10 / $16,184.00 / $28,048.48
| Facility | | $7,754.10 | $16,184.00 | $28,048.48 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,278.50 / $2,408.56 / $4,890.73
| Facility | | $2,278.50 | $2,408.56 | $4,890.73 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $238.75 / $238.75 / $238.75
| Facility | AS | $238.75 | $238.75 | $238.75 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,185.00 / $3,269.00 / $7,384.00
| Facility | | $1,185.00 | $3,269.00 | $7,384.00 |