- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,584.89 / $3,090.30 / $6,760.83
| Facility | | $1,584.89 | $3,090.30 | $6,760.83 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $549.54 / $1,778.28 / $2,691.53
| Facility | | $549.54 | $1,778.28 | $2,691.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $741.31 / $1,071.52 / $4,466.84
| Facility | | $741.31 | $1,071.52 | $4,466.84 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $204.17 / $204.17 / $501.19
| Facility | AS | $204.17 | $204.17 | $501.19 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,659.59 / $3,311.31 / $5,370.32
| Facility | | $1,659.59 | $3,311.31 | $5,370.32 |