- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,904.11 / $16,467.00 / $57,458.60
| Facility | | $1,904.11 | $16,467.00 | $57,458.60 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,123.46 / $15,705.45 / $43,667.88
| Facility | | $2,123.46 | $15,705.45 | $43,667.88 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $1,780.07
| Facility | | $890.00 | $890.00 | $1,780.07 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $176.68 / $176.68 / $176.68
| Facility | AS | $176.68 | $176.68 | $176.68 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,687.06 / $2,067.00 / $3,492.58
| Facility | | $1,687.06 | $2,067.00 | $3,492.58 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $364.35 / $419.82 / $712.78
| Facility | 80 | $364.35 | $419.82 | $712.78 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $255.05 / $289.38 / $498.95
| Facility | AS | $255.05 | $289.38 | $498.95 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,340.00 / $19,915.00 / $30,476.00
| Facility | | $3,340.00 | $19,915.00 | $30,476.00 |