- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $62.21 / $7,799.00 / $16,467.00
| Facility | | $62.21 | $7,799.00 | $16,467.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $9,401.93 / $21,277.44 / $33,889.28
| Facility | | $9,401.93 | $21,277.44 | $33,889.28 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $890.00 / $1,687.69
| Facility | | $580.00 | $890.00 | $1,687.69 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $167.58 / $167.58 / $167.58
| Facility | AS | $167.58 | $167.58 | $167.58 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,527.89 / $1,811.00 / $3,200.52
| Facility | | $1,527.89 | $1,811.00 | $3,200.52 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $334.60 / $362.20 / $605.79
| Facility | 80 | $334.60 | $362.20 | $605.79 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $233.93 / $253.54 / $419.86
| Facility | AS | $233.93 | $253.54 | $419.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |