- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,292.02 / $9,062.00 / $18,276.00
| Facility | | $1,292.02 | $9,062.00 | $18,276.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,783.09 / $10,824.58 / $20,677.25
| Facility | | $4,783.09 | $10,824.58 | $20,677.25 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $890.00 / $890.00 / $1,280.74
| Facility | | $890.00 | $890.00 | $1,280.74 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $127.13 / $127.13 / $127.13
| Facility | AS | $127.13 | $127.13 | $127.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,251.98 / $1,550.42 / $2,479.12
| Facility | | $1,251.98 | $1,550.42 | $2,479.12 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $272.94 / $320.00 / $474.47
| Facility | 80 | $272.94 | $320.00 | $474.47 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $191.06 / $224.00 / $332.13
| Facility | AS | $191.06 | $224.00 | $332.13 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,028.00 / $19,526.00 / $24,161.00
| Facility | | $3,028.00 | $19,526.00 | $24,161.00 |