- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $976.76 / $9,062.00 / $17,247.00
| Facility | | $976.76 | $9,062.00 | $17,247.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,680.97 / $8,102.13 / $17,426.25
| Facility | | $2,680.97 | $8,102.13 | $17,426.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $969.02 / $1,130.00 / $5,740.31
| Facility | | $969.02 | $1,130.00 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $96.34 / $96.34 / $96.34
| Facility | AS | $96.34 | $96.34 | $96.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $939.92 / $1,273.44 / $1,870.59
| Facility | | $939.92 | $1,273.44 | $1,870.59 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $205.88 / $274.80 / $358.45
| Facility | 80 | $205.88 | $274.80 | $358.45 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $144.11 / $192.36 / $250.92
| Facility | AS | $144.11 | $192.36 | $250.92 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,912.00 / $16,223.00 / $23,485.00
| Facility | | $2,912.00 | $16,223.00 | $23,485.00 |