- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $1,653.17 / $6,673.79 / $22,213.04
| Facility | | $1,653.17 | $6,673.79 | $22,213.04 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $2,891.10 / $9,358.28 / $19,712.46
| Facility | | $2,891.10 | $9,358.28 | $19,712.46 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $505.00 / $740.17 / $7,449.99
| Facility | | $505.00 | $740.17 | $7,449.99 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $73.45 / $73.45 / $73.45
| Facility | AS | $73.45 | $73.45 | $73.45 |
- Facility/Professional
- Facility
- Modifier
- Low / Median / High Price
- $716.55 / $924.14 / $1,538.47
| Facility | | $716.55 | $924.14 | $1,538.47 |
- Facility/Professional
- Facility
- Modifier
- 80
- Low / Median / High Price
- $161.86 / $238.12 / $318.39
| Facility | 80 | $161.86 | $238.12 | $318.39 |
- Facility/Professional
- Facility
- Modifier
- AS
- Low / Median / High Price
- $104.51 / $166.17 / $222.88
| Facility | AS | $104.51 | $166.17 | $222.88 |
- 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 |