- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,065.66 / $3,774.00 / $13,401.00
| Facility | | $1,065.66 | $3,774.00 | $13,401.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,305.36 / $2,230.01 / $8,947.21
| Facility | | $1,305.36 | $2,230.01 | $8,947.21 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $80.00 / $1,193.43 / $1,238.18
| Facility | | $80.00 | $1,193.43 | $1,238.18 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,487.30 / $1,487.30 / $1,487.30
| Facility | | $1,487.30 | $1,487.30 | $1,487.30 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.38 / $147.38 / $147.38
| Facility | AS | $147.38 | $147.38 | $147.38 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $55.00 / $5,000.00 / $20,745.75
| Facility | | $55.00 | $5,000.00 | $20,745.75 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $286.66 / $602.19 / $640.64
| Facility | AS | $286.66 | $602.19 | $640.64 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.74 / $1,622.45 / $2,507.23
| Facility | | $1,272.74 | $1,622.45 | $2,507.23 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,272.74 / $1,625.60 / $2,676.73
| Facility | | $1,272.74 | $1,625.60 | $2,676.73 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $498.37 / $498.37 / $498.37
| Facility | 80 | $498.37 | $498.37 | $498.37 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $147.38 / $147.38 / $423.62
| Facility | AS | $147.38 | $147.38 | $423.62 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,600.00 / $9,027.00 / $30,113.00
| Facility | | $4,600.00 | $9,027.00 | $30,113.00 |