- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,715.69 / $9,062.00 / $18,276.00
| Facility | | $1,715.69 | $9,062.00 | $18,276.00 |
- 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 / $1,724.24
| Facility | | $580.00 | $890.00 | $1,724.24 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $171.46 / $171.46 / $171.46
| Facility | AS | $171.46 | $171.46 | $171.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,618.85 / $1,948.00 / $3,314.91
| Facility | | $1,618.85 | $1,948.00 | $3,314.91 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $346.45 / $389.60 / $618.14
| Facility | 80 | $346.45 | $389.60 | $618.14 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $238.20 / $272.72 / $432.70
| Facility | AS | $238.20 | $272.72 | $432.70 |
- 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 |