- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,050.43 / $9,062.00 / $17,247.00
| Facility | | $1,050.43 | $9,062.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,654.80 / $9,293.40 / $16,513.82
| Facility | | $3,654.80 | $9,293.40 | $16,513.82 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,413.02 / $3,413.02 / $4,385.79
| Facility | | $3,413.02 | $3,413.02 | $4,385.79 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $849.22 / $1,076.52 / $1,980.41
| Facility | | $849.22 | $1,076.52 | $1,980.41 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $171.01 / $210.39 / $323.51
| Facility | 80 | $171.01 | $210.39 | $323.51 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $119.71 / $147.28 / $226.46
| Facility | AS | $119.71 | $147.28 | $226.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,959.00 / $23,485.00
| Facility | | $2,912.00 | $16,959.00 | $23,485.00 |