- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,008.22 / $9,062.00 / $25,106.31
| Facility | | $2,008.22 | $9,062.00 | $25,106.31 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $4,456.96 / $9,829.40 / $17,877.47
| Facility | | $4,456.96 | $9,829.40 | $17,877.47 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $580.00 / $858.91 / $5,740.31
| Facility | | $580.00 | $858.91 | $5,740.31 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $85.34 / $85.34 / $85.34
| Facility | AS | $85.34 | $85.34 | $85.34 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $827.20 / $1,043.08 / $1,651.74
| Facility | | $827.20 | $1,043.08 | $1,651.74 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $180.05 / $214.20 / $315.33
| Facility | 80 | $180.05 | $214.20 | $315.33 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $126.03 / $149.94 / $220.73
| Facility | AS | $126.03 | $149.94 | $220.73 |
- 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 |