- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $812.58 / $2,967.24 / $9,961.00
| Facility | | $812.58 | $2,967.24 | $9,961.00 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $5,084.66 / $9,152.37 / $17,945.84
| Facility | | $5,084.66 | $9,152.37 | $17,945.84 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $816.00 / $7,373.26 / $13,027.27
| Facility | | $816.00 | $7,373.26 | $13,027.27 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $803.83 / $5,924.93 / $5,924.93
| Facility | | $803.83 | $5,924.93 | $5,924.93 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $987.25 / $987.25 / $987.25
| Facility | | $987.25 | $987.25 | $987.25 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $98.72 / $98.72 / $98.72
| Facility | AS | $98.72 | $98.72 | $98.72 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $3,256.04 / $26,138.20 / $26,542.00
| Facility | | $3,256.04 | $26,138.20 | $26,542.00 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $199.35 / $2,477.53 / $2,477.53
| Facility | AS | $199.35 | $2,477.53 | $2,477.53 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $837.40 / $1,109.40 / $1,730.86
| Facility | | $837.40 | $1,109.40 | $1,730.86 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $847.06 / $1,109.98 / $1,751.16
| Facility | | $847.06 | $1,109.98 | $1,751.16 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $336.23 / $336.23 / $336.23
| Facility | 80 | $336.23 | $336.23 | $336.23 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $98.72 / $98.72 / $285.80
| Facility | AS | $98.72 | $98.72 | $285.80 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,605.00 / $7,184.00 / $16,000.00
| Facility | | $2,605.00 | $7,184.00 | $16,000.00 |