- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $441.42 / $7,679.70 / $17,287.11
| Facility | | $441.42 | $7,679.70 | $17,287.11 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,121.53 / $10,994.49 / $19,354.97
| Facility | | $4,121.53 | $10,994.49 | $19,354.97 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $444.46 / $444.46 / $890.00
| Facility | | $444.46 | $444.46 | $890.00 |
- Facility/Professional
- Facility
- Modifier
- 62
- Low / Median / High Price
- $272.63 / $272.63 / $272.63
| Facility | 62 | $272.63 | $272.63 | $272.63 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $43.62 / $43.62 / $43.62
| Facility | AS | $43.62 | $43.62 | $43.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $428.32 / $558.48 / $870.87
| Facility | | $428.32 | $558.48 | $870.87 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $95.84 / $118.20 / $179.98
| Facility | 80 | $95.84 | $118.20 | $179.98 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $67.09 / $82.74 / $125.99
| Facility | AS | $67.09 | $82.74 | $125.99 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $225.00 / $1,221.00 / $3,585.00
| Facility | | $225.00 | $1,221.00 | $3,585.00 |