- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.04 / $4,630.18 / $11,124.00
| Facility | | $1,224.04 | $4,630.18 | $11,124.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,696.32 / $5,696.32 / $8,139.33
| Facility | | $5,696.32 | $5,696.32 | $8,139.33 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $606.10 / $606.10 / $15,405.87
| Facility | | $606.10 | $606.10 | $15,405.87 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,224.04 / $1,754.18 / $2,952.36
| Facility | | $1,224.04 | $1,754.18 | $2,952.36 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $308.68 / $352.20 / $618.00
| Facility | 80 | $308.68 | $352.20 | $618.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $216.07 / $246.54 / $432.60
| Facility | AS | $216.07 | $246.54 | $432.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,015.00 / $15,545.00 / $22,780.00
| Facility | | $4,015.00 | $15,545.00 | $22,780.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $13,127.84 / $44,439.13 / $50,913.65
| Facility | | $13,127.84 | $44,439.13 | $50,913.65 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $276.56 / $2,901.37 / $4,825.89
| Facility | AS | $276.56 | $2,901.37 | $4,825.89 |